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Allo-HSCT for elderly patients with MF: Results from the German Registry for Stem Cell Transplantation study
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For patients with intermediate- or high-risk MF, allo-HSCT is typically recommended in patients aged <70 years.1 In recent years, an increased number of patients with MF aged ≥70 years have undergone allo-HSCT; however, data supporting allo-HSCT in these patients are limited.1 A multicenter, retrospective study using the DRST assessed the feasibility of allo-HSCT in 115 patients aged ≥70 years with MF.1 Results from this analysis were published in Transplantation and Cellular Therapy by Gagelmann et al.1 |
| Key learnings |
| The absolute number of allo-HSCT per year increased during 2007 to 2021, with a spike from 2019 onward. The HCT-CI of patients improved over time, and the proportion of patients receiving RIC increased. |
| Results suggest that allo-HSCT in patients aged ≥70 years with MF is feasible, with a 3-year OS rate of 55%. |
| The 1-year and 3-year CIR were 7% and 11%, respectively, and the 1-year and 3-year cumulative incidence of NRM were 22% and 38%, respectively. |
| The 100-day cumulative incidence of aGvHD and the cumulative incidence of cGvHD were 33% and 55%, respectively, and the 3-year estimated GRFS rate was 37%. Abbreviations: AE, adverse event; BAT, best available therapy; GI, gastrointestinal; MF, myelofibrosis; SVR35, spleen volume reduction. |
| Patients with unmutated CALR/MPL driver mutation genotype had lower survival compared with patients with CALR/MPL-mutated genotype (HR, 3.42; 95% CI, 1.01–11.60). HCT-CI and dose intensity did not impact survival. |
| This large, multicenter study demonstrated the survival benefit of allo-HSCT in patients aged ≥70 years with MF and highlights an increase in allo-HSCT rates and patient fitness in recent years. |
Abbreviations: aGvHD, acute graft-versus-host disease; allo-HSCT, allogeneic hematopoietic stem cell transplantation; cGvHD, chronic graft-versus-host disease; CI, confidence interval; CIR, cumulative incidence of relapse; DRST, German Registry for Stem Cell Transplantation; GRFS, graft-versus-host disease and relapse-free survival; HCT-CI, Hematopoietic Cell Transplantation-specific Comorbidity Index; HR, hazard ratio; MF, myelofibrosis; NRM, non-relapse mortality; OS, overall survival; RIC, reduced-intensity conditioning.
- Gagelmann N, Schuh C, Zeiser R, et al. Allogeneic hematopoietic cell transplantation for myelofibrosis aged 70 years or older: A study from the German Registry for Stem Cell Transplantation. Transplant Cell Ther. 2024;30(10):1011.e1-1011.e13. DOI: 1016/j.jtct.2024.07.026
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