TY - JOUR
T1 - Hematopoietic Cell Transplantation for Myelofibrosis
T2 - the Dynamic International Prognostic Scoring System Plus Risk Predicts Post-Transplant Outcomes
AU - Samuelson Bannow, Bethany T.
AU - Salit, Rachel B.
AU - Storer, Barry E.
AU - Stevens, Emily A.
AU - Wu, David
AU - Yeung, Cecilia
AU - Fang, Min
AU - Petersdorf, Effie W.
AU - Linenberger, Michael L.
AU - Woo, Janghee
AU - Sorror, Mohamed L.
AU - Doney, Kris
AU - Sandmaier, Brenda M.
AU - Deeg, H. Joachim
AU - Scott, Bart L.
N1 - Publisher Copyright:
© 2017 The American Society for Blood and Marrow Transplantation
PY - 2018/2
Y1 - 2018/2
N2 - Hematopoietic cell transplantation (HCT) provides potentially curative treatment for patients with myelofibrosis (MF). HCT outcomes are associated with the Dynamic International Prognostic Scoring System (DIPSS) risk scores. In the present study we analyzed results in 233 patients to determine if the DIPSS plus classification, which adds cytogenetics, thrombocytopenia, and RBC transfusion dependence as risk factors, would better predict post-HCT outcomes than the original DIPSS. Multivariate analysis showed that each risk parameter incorporated into the DIPPS plus model contributed to its predictive power of overall mortality, relapse-free survival, and nonrelapse mortality. The 5-year overall survival (OS), relapse, and treatment-related mortality (TRM) rates for patients with low/intermediate-1 risk MF were 78%, 5%, and 20%, respectively. The 5-year OS, relapse, and TRM rates for patients with high-risk MF were 35%, 28%, and 40%, respectively. The HCT-specific comorbidity index of 3 or greater was associated with higher nonrelapse and overall mortality and reduced relapse-free survival. The relapse incidence was significantly increased in older patients (HR, 3.02; P =.0007). With a median follow-up of 8 years 124 patients (53%) were surviving. The components of the DIPSS plus classification still have prognostic relevance after adjustment by the DIPSS classification. This information should enhance our ability to advise patients when making decisions regarding timing of transplant.
AB - Hematopoietic cell transplantation (HCT) provides potentially curative treatment for patients with myelofibrosis (MF). HCT outcomes are associated with the Dynamic International Prognostic Scoring System (DIPSS) risk scores. In the present study we analyzed results in 233 patients to determine if the DIPSS plus classification, which adds cytogenetics, thrombocytopenia, and RBC transfusion dependence as risk factors, would better predict post-HCT outcomes than the original DIPSS. Multivariate analysis showed that each risk parameter incorporated into the DIPPS plus model contributed to its predictive power of overall mortality, relapse-free survival, and nonrelapse mortality. The 5-year overall survival (OS), relapse, and treatment-related mortality (TRM) rates for patients with low/intermediate-1 risk MF were 78%, 5%, and 20%, respectively. The 5-year OS, relapse, and TRM rates for patients with high-risk MF were 35%, 28%, and 40%, respectively. The HCT-specific comorbidity index of 3 or greater was associated with higher nonrelapse and overall mortality and reduced relapse-free survival. The relapse incidence was significantly increased in older patients (HR, 3.02; P =.0007). With a median follow-up of 8 years 124 patients (53%) were surviving. The components of the DIPSS plus classification still have prognostic relevance after adjustment by the DIPSS classification. This information should enhance our ability to advise patients when making decisions regarding timing of transplant.
KW - DIPSS plus
KW - Dynamic International Prognostic Scoring System (DIPSS)
KW - Hematopoietic cell transplantation
KW - Myelofibrosis
UR - http://www.scopus.com/inward/record.url?scp=85033404906&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85033404906&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2017.09.016
DO - 10.1016/j.bbmt.2017.09.016
M3 - Article
C2 - 28970176
AN - SCOPUS:85033404906
SN - 1083-8791
VL - 24
SP - 386
EP - 392
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 2
ER -