Ruxolitinib before allogeneic hematopoietic transplantation in patients with myelofibrosis on behalf SFGM-TC and FIM groups.

Graft vs Host Disease Hematopoietic Stem Cell Transplantation Humans Nitriles Primary Myelofibrosis / therapy Prospective Studies Pyrazoles Pyrimidines Transplantation Conditioning Unrelated Donors

Journal

Bone marrow transplantation

ISSN: 1476-5365

Titre abrégé: Bone Marrow Transplant

Pays: England

ID NLM: 8702459

Informations de publication

Date de publication:
08 2021

Historique:

received: 04 12 2020

accepted: 19 02 2021

revised: 28 01 2021

pubmed: 27 3 2021

medline: 14 10 2021

entrez: 26 3 2021

Statut: ppublish

Résumé

This multicenter prospective phase 2 trial analyzed disease-free survival (DFS) in myelofibrosis patients receiving ruxolitinib for 6 months before transplantation. Seventy-six patients were recruited. Age-adjusted dynamic international prognostic scoring system was intermediate-1, intermediate-2, and high in 27 (36%), 31 (41%), and 18 (24%) patients. All patients received ruxolitinib from inclusion to conditioning regimen (fludarabine-melphalan) or to progression. A donor was found in 64 patients: 18 HLA-matched sibling donor (MSD), 32 HLA-matched unrelated (UD10/10), and 14 HLA mismatched unrelated donor (UD9/10. Among 64 patients with a donor, 20 (31%) achieved a partial response before transplantation and 59 (92%) could be transplanted after ruxolitinib therapy (18/18 MSD, 30/21 UD10/10, 11/34 UD9/10), of whom 19 (32%) were splenectomized. Overall survival from inclusion was 68% at 12 months. One-year DFS after transplantation was 55%: 83%, 40%, and 34% after MSD, UD10/10 or UD9/10, respectively. Cumulative incidence of grade 2-4 acute graft-versus-host disease (GVHD) was 66% and non-relapse-mortality was 42% at 12 months. Short course of ruxolitinib before transplantation is followed by a high rate of transplantation. With the platform used in this protocol, outcome was much better in patients transplanted with HLA-matched sibling donor as compared to unrelated donor.

Identifiants

DOI: 10.1038/s41409-021-01252-7 PMID: 33767402 PMC: PMC7992510

pubmed: 33767402

doi: 10.1038/s41409-021-01252-7

pii: 10.1038/s41409-021-01252-7

pmc: PMC7992510

doi:

Substances chimiques

Nitriles 0

Pyrazoles 0

Pyrimidines 0

ruxolitinib 82S8X8XX8H

Types de publication

Clinical Trial, Phase II Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

1888-1899

Informations de copyright

Références

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