Publicaciones científicas
Transplantation for myelofibrosis patients in the ruxolitinib era: a registry study from the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire
Sara Villar 1 2 , Sylvie Chevret 3 , Xavier Poire 4 , Magalie Joris 5 , Patrice Chevallier 6 , Jean-Henri Bourhis 7 , Edouard Forcade 8 , Sylvain Chantepie 9 , David Beauvais 10 , Nicole Raus 11 , Jacques-Olivier Bay 12 , Michael Loschi 13 , Raynier Devillier 14 , Remy Duléry 15 , Patrice Ceballos 16 , Marie Thérèse Rubio 17 18 , Sophie Servais 19 , Stephanie Nguyen 20 , Marie Robin 21
Abstract
In this SFGM-TC registry study, we report the results after stem cell transplantation (HSCT) in 305 myelofibrosis patients, in order to determine potential risk factors associated with outcomes, especially regarding previous treatment with ruxolitinib. A total of 102 patients were transplanted from an HLA-matched-sibling donor (MSD), and 143 patients received ruxolitinib. In contrast with previous studies, our results showed significantly worse outcomes for ruxolitinib patients regarding overall survival (OS) and non-relapse mortality (NRM), especially in the context of unrelated donors (URD).
When exploring reasons for potential confounders regarding the ruxolitinib effect, an interaction between the type of donor and the use of ATG was found, therefore subsequent analyses were performed separately for each type of donor. Multivariable analyses did not confirm a significant negative impact of ruxolitinib in transplantation outcomes. In the setting of URD, only age and Fludarabine-Melphalan (FM) conditioning were associated with increased NRM.
For MSD, only Karnoksfy <70% was associated with reduced OS. However, a propensity score analysis showed that ruxolitinib had a negative impact on OS but only in non-responding patients, consistent with previous data. To conclude, with all the precautions due to confounders and bias, ruxolitinib itself does not appear to increase mortality after HSCT.
CITA DEL ARTÍCULO Bone Marrow Transplant. 2024 Mar 21. doi: 10.1038/s41409-024-02268-5
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