Allogeneic stem cell transplantation after reduced-intensity conditioning in patients with myelofibrosis: a prospective, multicenter study of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation

Kröger, Nicolaus ; Holler, Ernst ; Kobbe, Guido ; Bornhäuser, Martin ; Schwerdtfeger, Rainer ; Baurmann, Herrad ; Nagler, Arnon ; Bethge, Wolfgang ; Stelljes, Matthias ; Uharek, Lutz ; Wandt, Hannes ; Burchert, Andreas ; Corradini, Paolo ; Schubert, Jörg ; Kaufmann, Martin ; Dreger, Peter ; Wulf, Gerald G. ; Einsele, Hermann ; Zabelina, Tatjana ; Kvasnicka, Hans Michael ; Thiele, Jürgen ; Brand, Ronald ; Zander, Axel R. ; Niederwieser, Dietger ; de Witte, Theo M.

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Details

Dokumentenart:	Artikel
Titel eines Journals oder einer Zeitschrift:	Blood
Verlag:	AMER SOC HEMATOLOGY
Ort der Veröffentlichung:	WASHINGTON
Band:	114
Nummer des Zeitschriftenheftes oder des Kapitels:	26
Seitenbereich:	S. 5264-5270
Datum:	2009
Institutionen:	Medizin > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie)
Identifikationsnummer:	Wert Typ 10.1182/blood-2009-07-234880 DOI
Stichwörter / Keywords:	AGNOGENIC MYELOID METAPLASIA; DONOR-LYMPHOCYTE INFUSION; IDIOPATHIC MYELOFIBROSIS; ESSENTIAL THROMBOCYTHEMIA; MYELOPROLIFERATIVE DISORDERS; PROGNOSTIC-FACTORS; GRUPPO-ITALIANO; MIDOLLO-OSSEO; GRAFT; MUTATION;
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	66671

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Zusammenfassung

From 2002 to 2007, 103 patients with primary myelofibrosis or postessential thrombocythemia and polycythemia vera myelofibrosis and a median age of 55 years (range, 32-68 years) were included in a prospective multicenter phase 2 trial to determine efficacy of a busulfan (10 mg/kg)/fludarabine (180 mg/m(2))-based reduced-intensity conditioning regimen followed by allogeneic stem cell ...

Zusammenfassung

From 2002 to 2007, 103 patients with primary myelofibrosis or postessential thrombocythemia and polycythemia vera myelofibrosis and a median age of 55 years (range, 32-68 years) were included in a prospective multicenter phase 2 trial to determine efficacy of a busulfan (10 mg/kg)/fludarabine (180 mg/m(2))-based reduced-intensity conditioning regimen followed by allogeneic stem cell transplantation from related (n = 33) or unrelated donors (n = 70). All but 2 patients (2%) showed leukocyte and platelet engraftment after a median of 18 and 22 days, respectively. Acute graft-versus-host disease grade 2 to 4 occurred in 27% and chronic graft-versus-host disease in 43% of the patients. Cumulative incidence of nonrelapse mortality at 1 year was 16% (95% confidence interval, 9%-23%) and significantly lower for patients with a completely matched donor (12% vs 38%; P = .003). The cumulative incidence of relapse at 3 years was 22% (95% confidence interval, 13%-31%) and was influenced by Lille risk profile (low, 14%; inter-mediate, 22%; and high, 34%; P = .02). The estimated 5-year event-free and overall survival was 51% and 67%, respectively. In a multivariate analysis, age older than 55 years (hazard ratio = 2.70; P = .02) and human leukocyte antigen-mismatched donor (hazard ratio = 3.04; P = .006) remained significant factors for survival. The study was registered at www.clinicaltrials.gov as # NCT 00599547. (Blood. 2009; 114: 5264-5270)

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