000041302 001__ 41302
000041302 005__ 20240415075912.0
000041302 0247_ $$2doi$$a10.6083/bpxhc41302
000041302 037__ $$aIR
000041302 041__ $$aeng
000041302 245__ $$aOverall survival in myelofibrosis treated with allogeneic hematopoietic cell transplant is impacted by reversal of marrow fibrosis: a single institution experience from Oregon Health & Science University
000041302 260__ $$bOregon Health and Science University
000041302 269__ $$a2023-07-19
000041302 336__ $$aAbstract
000041302 520__ $$aAllogeneic hematopoietic cell transplantation (allo HCT) is the only curative therapy for patients with intermediate-2 or high risk myelofibrosis (MF). We sought to examine the impact of pre-HCT splenomegaly, splenic RT, and marrow fibrosis on overall survival (OS). Subjects with primary or secondary MF who underwent allo HCT using matched related (n=10) or unrelated (n=24) donor grafts, PBSC (n=33) or marrow (n=1), between 2005 and 2021 were identified. Median follow-up was estimated by reverse Kaplan-Meier (KM). Marrow fibrosis regression (defined as any decrease in grade) and GVHD were considered time-varying predictors. Time-to-engraftment and OS were modeled by Cox regression, while post-HCT death rates were estimated via the extended KM method. Logistic regression was used to model fibrosis regression by a specified time point. Our data on engraftment, GVHD, and survival are comparable to that reported by the CIBMTR with this analysis demonstrating a strong correlation between aGVHD, lack of marrow fibrosis regression, and increased risk of death. Novel strategies, such as the use of peri-HCT JAK inhibition and T cell depletion (in-and ex-vivo), may provide rapid marrow remodeling and improve OS in MF patients.
000041302 540__ $$fCC BY
000041302 542__ $$fIn copyright - joint owners
000041302 650__ $$aMolecular Biology$$022384
000041302 650__ $$aCell Biology$$017350
000041302 650__ $$aPrimary Myelofibrosis$$038442
000041302 650__ $$aCell Transplantation$$030164
000041302 650__ $$aBone Marrow$$015725
000041302 650__ $$aBone Marrow Diseases$$015727
000041302 6531_ $$aallogeneic
000041302 6531_ $$aallogeneic stem cell transplantation
000041302 691__ $$aSchool of Medicine$$041369
000041302 692__ $$aDivision of Hematology and Medical Oncology$$041461
000041302 7001_ $$aGutierrez, Anthony$$uOregon Health and Science University$$041354
000041302 7001_ $$aGandhi, Arpita$$uOregon Health and Science University$$041354
000041302 7001_ $$aKaempf, Andy$$uOregon Health and Science University$$041354
000041302 7001_ $$aSaultz, Jennifer N.$$uOregon Health and Science University$$041354
000041302 7001_ $$aXie, Wei$$uOregon Health and Science University$$041354
000041302 7001_ $$aCook, Rachel$$uOregon Health and Science University$$041354
000041302 7001_ $$aMigdady, Yazan$$uOregon Health and Science University$$041354
000041302 7001_ $$aSchachter, Levanto$$uOregon Health and Science University$$041354
000041302 7001_ $$aSlater, Susan$$uOregon Health and Science University$$041354
000041302 7001_ $$aMeyers, Gabrielle$$uOregon Health and Science University$$041354
000041302 7001_ $$aMaziarz, Richard T.$$uOregon Health and Science University$$041354
000041302 711__ $$aResearch Week$$uOregon Health and Science University$$d2023
000041302 7201_ $$aGandhi, Arpita$$7Personal
000041302 8564_ $$9b4a678c7-3f8c-4c5d-9a1a-c4ef7e15c39c$$s234560$$uhttps://digitalcollections.ohsu.edu/record/41302/files/ResearchWeek.2023.Gutierrez.Anthony.pdf
000041302 980__ $$aResearch Week
000041302 981__ $$aPublished$$b2023-07-19