Outcomes after Allogeneic Hematopoietic Cell Transplant in patients diagnosed with Blast Phase of Myeloproliferative Neoplasms: a retrospective study from the Chronic Malignancies Working Party of the EBMT. - Université de Lille Accéder directement au contenu
Article Dans Une Revue American Journal of Hematology Année : 2023

Outcomes after Allogeneic Hematopoietic Cell Transplant in patients diagnosed with Blast Phase of Myeloproliferative Neoplasms: a retrospective study from the Chronic Malignancies Working Party of the EBMT.

Edouard Forcade
  • Fonction : Auteur
Tsila Zuckerman
  • Fonction : Auteur

Résumé

Allogeneic hematopoietic cell transplant (allo-HCT) provides the only potential route to long-term remission in patients diagnosed with blast phase transformation of myeloproliferative neoplasm (BP-MPN). We report on a large, retrospective European Society for Blood and Marrow Transplantation registry-based study of BP-MPN patients undergoing allo-HCT. BP-MPN patients undergoing first allo-HCT between 2005 and 2019 were included. A total of 663 patients were included. With a median follow-up of 62 months, the estimated 3-year overall survival (OS) was 36% (95% confidence interval [CI], 32–36). Factors associated with lower OS were Karnofsky Performance Score (KPS) <90 (hazard ratio [HR] 1.65, p < .001) and active disease at allo-HCT (HR 1.45, p < .001), whereas patients undergoing allo-HCT more recently associated with a higher OS (HR 0.96, p = .008). In a selected patient's population, the 3-year OS of patients undergoing allo-HCT in complete response (CR) and with a KPS ≥90 was 60%. KPS < 90 (HR 1.4, p = .001) and active disease (HR 1.44, p = .0004) were associated with a lower progression-free survival (PFS). Conversely, most recent allo-HCT associated with a higher PFS (HR 0.96, p = .008). Active disease at allo-HCT (HR 1.34, p = .03) was associated with a higher cumulative incidence of relapse (RI) and allo-HCT in earlier calendar years (HR 0.96, p = .02) associated with a lower RI. Last, KPS < 90 (HR 1.91, p < .001), active disease (HR 1.74, p = .003) and allo-HCT from mismatched related donors were associated with a higher non-relapse mortality (HR 2.66, p = .003). In this large series of BP-MPN patients, about one third were alive at 3 years after transplantation. Patients undergoing allo-HCT in the more recent era, with a KPS ≥90 and in CR at transplant had a better prognosis.
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Dates et versions

hal-04523135 , version 1 (27-03-2024)

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Citer

Guillermo Ortí, Luuk Gras, Nienke Zinger, Maria Chiara Finazzi, Katja Sockel, et al.. Outcomes after Allogeneic Hematopoietic Cell Transplant in patients diagnosed with Blast Phase of Myeloproliferative Neoplasms: a retrospective study from the Chronic Malignancies Working Party of the EBMT.. American Journal of Hematology, 2023, American Journal of Hematology, ⟨10.1002/ajh.26833⟩. ⟨hal-04523135⟩
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