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Allografting

Allogeneic hemopoietic SCT for patients with primary myelofibrosis: a predictive transplant score based on transfusion requirement, spleen size and donor type

Bone Marrow Transplantation volume 45, pages 458–463 (2010)Cite this article

Abstract

A total of 46 patients with primary myelofibrosis (PMF) (median age 51 years), underwent an allogeneic hemopoietic SCT (HSCT) after a thiotepa-based reduced-intensity conditioning regimen. The median follow-up for surviving patients is 3.8 years. In multivariate analysis, independent unfavorable factors for survival were RBC transfusions >20, a spleen size >22 cm and an alternative donor—24 patients had 0–1 unfavorable predictors (low risk) and 22 patients had 2 or more negative predictors (high risk). The overall actuarial 5-year survival of the 46 patients is 45%. The actuarial survival of low-risk and high-risk patients is, respectively, 77 and 8% (P<0.0001); this is because of a higher TRM for high-risk patients (RR, 6.0, P=0.006) and a higher relapse-related death (RR, 7.69; P=0.001). In multivariate Cox analysis, the score maintained its predictive value (P=0.0003), even after correcting for donor–patient age and gender, Dupriez score, IPSS (International Prognostic Scoring System) score pre-transplant and splenectomy. In conclusion, PMF patients undergoing an allogeneic HSCT may be scored according to the spleen size, transfusion history and donor type; this scoring system may be useful to discuss transplant strategies.

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Acknowledgements

This work was supported, in part, by the Associazione Italiana Ricerca contro il Cancro (AIRC-Milano) and the Fondazione Ricerca Trapianto Midollo Osseo (FARITMO).

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Authors and Affiliations

  1. Divisione Ematologia e Trapianto di Midollo Ospedale San Martino, Genova, Italy

    A Bacigalupo, A Dominietto, S Pozzi, S Geroldi, M T Van Lint, A Ibatici, A M Raiola & F Frassoni

  2. Divisione di Oncologia, Ospedale Camposampiero, Padova, Italy

    M Soraru

  3. Cattedra Medicina Legale Universita, Genova, Italy

    F De Stefano, S Verdiani & L Casarino

  4. Unita' di Epidemiologia Clinica–Centro per lo studio della Mielofibrosi, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy

    G Barosi

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  1. A Bacigalupo
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Correspondence to A Bacigalupo.

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Bacigalupo, A., Soraru, M., Dominietto, A. et al. Allogeneic hemopoietic SCT for patients with primary myelofibrosis: a predictive transplant score based on transfusion requirement, spleen size and donor type. Bone Marrow Transplant 45, 458–463 (2010). https://doi.org/10.1038/bmt.2009.188

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