Dynamic of Bone Marrow Fibrosis Regression Predicts Survival after Allogeneic Stem Cell Transplantation for Myelofibrosis

作者：Kroeger Nicolaus; Zabelina Tatjana; Alchalby Haefaa; Stuebig Thomas; Wolschke Christine; Ayuk Francis; von Huenerbein Natascha; Kvasnicka Hans Michael; Thiele Juergen; Kreipe Hans Heinrich; Buesche Guntram

来源：Biology of Blood and Marrow Transplantation, 2014, 20(6): 812-815.

DOI：10.1016/j.bbmt.2014.02.019

• Bone marrow fibrosis
• Fibrosis regression
• Myelofibrosis
• Allogeneic stem cell transplantation
• JAK2 mutation

We correlate regression of bone marrow fibrosis (BMF) on day 30 and 100 after dose- reduced allogeneic stem cell transplantation (allo-SCT) in 57 patients with primary or post-essential thrombocythemia/polycythemia vera myelofibrosis with graft function and survival. The distribution of International Prognostic Scoring System (IPSS) risk score categories was 1 patient with low risk, 5 patients with intermediate-1 risk, 18 patients with intermediate-2 risk, and 33 patients with high risk. Before allo-SCT, 41 patients (72%) were classified as XXX [myclofibrosis (MF)]-3 and 16 (28%) were classified as MF-2 according to the World Health Organization criteria. At postengraftment day +30 (+/- 10 days), 21% of the patients had near-complete or complete regression of BMF (MF-0/-1), and on day +100 ( 20 days), 54% were MF-0/-1. The 5-year overall survival rate at day +100 was 96% in patients with MF-0/-1 and 57% for those with MF-2/-3 (P = .04). There was no difference in BMF regression at day +100 between IPSS high-risk and low/intermediate-risk patients. Complete donor cell chimerism at day +100 was seen in 81% of patients with MF-0/-1 and in 31% of those with MF-2/-3. Patients with MF-2/-3 at day +100 were more likely to be transfusion-dependent for either RBCs (P = .014) or platelets (P = .018). Rapid BMF regression after reduced-intensity conditioning allo-SCT resulted in a favorable survival independent of IPSS risk score at transplantation.

• 出版日期2014-6