Transplantation for myelofibrosis patients in the ruxolitinib era: a registry study from the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire. - 2024
Transplantation for myelofibrosis patients in the ruxolitinib era: a registry study from the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire.
[en] 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.
Disciplines :
Hematology
Author, co-author :
Villar, Sara ; Service d'hématologie - greffe, Hôpital Saint Louis, APHP, Université de Paris, Paris, France ; Hematology Department, Clínica Universidad de Navarra, Pamplona, Spain
Chevret, Sylvie; APHP, Saint-Louis University Hospital, Department of Biostatistics, Paris, France
Joris, Magalie; Hematology Department, CHU Amiens, Amiens, France
Chevallier, Patrice ; Hematology Department, Nantes University Hospital, Nantes, France
Bourhis, Jean-Henri; Hematology Department, Institut Gustave Roussy, Villejuif, France
Forcade, Edouard ; Service d'hématologie et thérapie Cellulaire, CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France
Chantepie, Sylvain; Hematology Department, Caen University Hospital, Caen, France
Beauvais, David ; Hematology Department, CHU de Lille, Lille, France
Raus, Nicole; SFGM-TC, Lyon, France
Bay, Jacques-Olivier; Department of Clinical Hematology and Cellular Therapy, CHU de Clermont-Ferrand, Site Estaing, Clermont-Ferrand, France
Loschi, Michael ; Hematology Department, Cote D'Azur University, CHU of Nice, Nice, France
Devillier, Raynier ; Hematology Department, Institut Paoli Calmettes, Marseille, France
Duléry, Remy ; Department of Clinical Hematology and Cellular Therapy, Centre de Recherche Saint-Antoine (CRSA), Saint-Antoine Hospital, Assistance Publique - Hôpitaux de Paris, INSERM UMRs 938 Sorbonne University, Paris, France
Ceballos, Patrice; Hematology Department, Montpellier University Hospital, Montpellier, France, Montpellier, France
Rubio, Marie Thérèse; Hematology Department, CHRU Brabois, Nancy, France ; CNRS UMR 7365, Équipe 6, Biopôle de L'Université de Lorraine, Vandoeuvre Les Nancy, France
Servais, Sophie ; Université de Liège - ULiège > Département des sciences cliniques
Nguyen, Stephanie; Hematology Department, Pitié Salpêtrière Hospital, AP-HP, Paris, France
Robin, Marie ; Service d'hématologie - greffe, Hôpital Saint Louis, APHP, Université de Paris, Paris, France. marie.robin@aphp.fr
Transplantation for myelofibrosis patients in the ruxolitinib era: a registry study from the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire.
The authors declare no competing interests in relationship with the current study. MR: research support by Novartis, MEDAC, NEOVII, ASTEX, ABBVIE. RD: research funding from Ligue contre le Cancer, Arthur Sachs, Monahan Foundation, Servier Foundation, Philippe Foundation, DCP AP-HP, honoraria from Novartis and Takeda, and non-financial support from Kite Pharma/Gilead, all outside the submitted work.
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