Impact of prior JAK-inhibitor therapy with ruxolitinib on outcome after allogeneic hematopoietic stem cell transplantation for myelofibrosis: a study of the CMWP of EBMT.
Adult
Aged
Female
Graft vs Host Disease
/ immunology
Hematopoietic Stem Cell Transplantation
/ methods
Humans
Janus Kinase Inhibitors
/ therapeutic use
Male
Middle Aged
Nitriles
/ therapeutic use
Primary Myelofibrosis
/ drug therapy
Pyrazoles
/ therapeutic use
Pyrimidines
/ therapeutic use
Recurrence
Retrospective Studies
Survival Rate
Treatment Outcome
Journal
Leukemia
ISSN: 1476-5551
Titre abrégé: Leukemia
Pays: England
ID NLM: 8704895
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
25
01
2021
accepted:
29
04
2021
revised:
07
04
2021
pubmed:
24
5
2021
medline:
29
1
2022
entrez:
23
5
2021
Statut:
ppublish
Résumé
JAK1/2 inhibitor ruxolitinib (RUX) is approved in patients with myelofibrosis but the impact of pretreatment with RUX on outcome after allogeneic hematopoietic stem cell transplantation (HSCT) remains to be determined. We evaluated the impact of RUX on outcome in 551 myelofibrosis patients who received HSCT without (n = 274) or with (n = 277) RUX pretreatment. The overall leukocyte engraftment on day 45 was 92% and significantly higher in RUX responsive patients than those who had no or lost response to RUX (94% vs. 85%, p = 0.05). The 1-year non-relapse mortality was 22% without significant difference between the arms. In a multivariate analysis (MVA) RUX pretreated patients with ongoing spleen response at transplant had a significantly lower risk of relapse (8.1% vs. 19.1%; p = 0.04)] and better 2-year event-free survival (68.9% vs. 53.7%; p = 0.02) in comparison to patients without RUX pretreatment. For overall survival the only significant factors were age > 58 years (p = 0.03) and HLA mismatch donor (p = 0.001). RUX prior to HSCT did not negatively impact outcome after transplantation and patients with ongoing spleen response at time of transplantation had best outcome.
Identifiants
pubmed: 34023851
doi: 10.1038/s41375-021-01276-4
pii: 10.1038/s41375-021-01276-4
pmc: PMC8632691
doi:
Substances chimiques
Janus Kinase Inhibitors
0
Nitriles
0
Pyrazoles
0
Pyrimidines
0
ruxolitinib
82S8X8XX8H
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3551-3560Informations de copyright
© 2021. The Author(s).
Références
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