TY  - GEN
N2  - Allogeneic hematopoietic cell transplantation (allo HCT) is the only curative therapy for patients with intermediate-2 or high risk myelofibrosis (MF). We sought to examine the impact of pre-HCT splenomegaly, splenic RT, and marrow fibrosis on overall survival (OS). Subjects with primary or secondary MF who underwent allo HCT using matched related (n=10) or unrelated (n=24) donor grafts, PBSC (n=33) or marrow (n=1), between 2005 and 2021 were identified. Median follow-up was estimated by reverse Kaplan-Meier (KM). Marrow fibrosis regression (defined as any decrease in grade) and GVHD were considered time-varying predictors. Time-to-engraftment and OS were modeled by Cox regression, while post-HCT death rates were estimated via the extended KM method. Logistic regression was used to model fibrosis regression by a specified time point. Our data on engraftment, GVHD, and survival are comparable to that reported by the CIBMTR with this analysis demonstrating a strong correlation between aGVHD, lack of marrow fibrosis regression, and increased risk of death. Novel strategies, such as the use of peri-HCT JAK inhibition and T cell depletion (in-and ex-vivo), may provide rapid marrow remodeling and improve OS in MF patients.
DO  - 10.6083/bpxhc41302
DO  - doi
AB  - Allogeneic hematopoietic cell transplantation (allo HCT) is the only curative therapy for patients with intermediate-2 or high risk myelofibrosis (MF). We sought to examine the impact of pre-HCT splenomegaly, splenic RT, and marrow fibrosis on overall survival (OS). Subjects with primary or secondary MF who underwent allo HCT using matched related (n=10) or unrelated (n=24) donor grafts, PBSC (n=33) or marrow (n=1), between 2005 and 2021 were identified. Median follow-up was estimated by reverse Kaplan-Meier (KM). Marrow fibrosis regression (defined as any decrease in grade) and GVHD were considered time-varying predictors. Time-to-engraftment and OS were modeled by Cox regression, while post-HCT death rates were estimated via the extended KM method. Logistic regression was used to model fibrosis regression by a specified time point. Our data on engraftment, GVHD, and survival are comparable to that reported by the CIBMTR with this analysis demonstrating a strong correlation between aGVHD, lack of marrow fibrosis regression, and increased risk of death. Novel strategies, such as the use of peri-HCT JAK inhibition and T cell depletion (in-and ex-vivo), may provide rapid marrow remodeling and improve OS in MF patients.
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
AD  - Oregon Health and Science University
T1  - Overall survival in myelofibrosis treated with allogeneic hematopoietic cell transplant is impacted by reversal of marrow fibrosis: a single institution experience from Oregon Health & Science University
ED  - Gandhi, Arpita
DA  - 2023-07-19
AU  - Gutierrez, Anthony
AU  - Gandhi, Arpita
AU  - Kaempf, Andy
AU  - Saultz, Jennifer N.
AU  - Xie, Wei
AU  - Cook, Rachel
AU  - Migdady, Yazan
AU  - Schachter, Levanto
AU  - Slater, Susan
AU  - Meyers, Gabrielle
AU  - Maziarz, Richard T.
L1  - https://digitalcollections.ohsu.edu/record/41302/files/ResearchWeek.2023.Gutierrez.Anthony.pdf
PB  - Oregon Health and Science University
LA  - eng
PY  - 2023-07-19
ID  - 41302
L4  - https://digitalcollections.ohsu.edu/record/41302/files/ResearchWeek.2023.Gutierrez.Anthony.pdf
KW  - Molecular Biology
KW  - Cell Biology
KW  - Primary Myelofibrosis
KW  - Cell Transplantation
KW  - Bone Marrow
KW  - Bone Marrow Diseases
KW  - allogeneic
KW  - allogeneic stem cell transplantation
TI  - Overall survival in myelofibrosis treated with allogeneic hematopoietic cell transplant is impacted by reversal of marrow fibrosis: a single institution experience from Oregon Health & Science University
Y1  - 2023-07-19
L2  - https://digitalcollections.ohsu.edu/record/41302/files/ResearchWeek.2023.Gutierrez.Anthony.pdf
LK  - https://digitalcollections.ohsu.edu/record/41302/files/ResearchWeek.2023.Gutierrez.Anthony.pdf
UR  - https://digitalcollections.ohsu.edu/record/41302/files/ResearchWeek.2023.Gutierrez.Anthony.pdf
ER  -