Impact of ruxolitinib pretreatment on outcomes after allogeneic stem cell transplantation in patients with myelofibrosis
Impact of ruxolitinib pretreatment on outcomes after allogeneic stem cell transplantation in patients with myelofibrosis
复制标题
DOI：
10.1111/ejh.13099
复制
发表时间：
2018-09-01
影响因子：
3.1
通讯作者：
Kroeger, Nicolaus
中科院分区：
文献类型：
--
作者：
Abd Kadir, Sharifah Shahnaz Syed;Christopeit, Maximilian;Kroeger, Nicolaus
ruxolitinib是首个被批准用于治疗骨髓纤维化的药物，但其对同种异体干细胞移植（ASCT）后预后的影响尚不清楚。患者和方法我们报道了来自8个德国中心的159名骨髓纤维化患者（pts），他们在2000年至2015年间接受了降低强度的ASCT，这些患者来自相关（n=23）、匹配（n=86）或错配（n=50）非亲属供体。46例（29%）患者在ASCT前的任何时间点接受ruxolitinib治疗。ruxolitinib的中位每日剂量为30mg（范围10-40mg），中位治疗持续时间为4.9个月（范围0.4-39.1个月）。结果鲁索利替尼组2例（4%）患者出现原发性移植物衰竭，非鲁索利替尼组3例（2%）患者出现原发性移植物衰竭。移植和急性GVHD II至IV级和III/IV级的发生率在两组之间没有差异（分别为37%对39%和19%对28%），2年非复发死亡率也没有差异（23%对23%）。ruxolitinib组有较低复发风险的趋势（9% vs 17%， P= 0.2），导致2年DFS和OS相似（分别为68% vs 60%和73% vs 70%）。在ruxolitinib应答者和对ruxolitinib无效或失去应答者之间，没有任何结果变量的差异。结论鲁索利替尼预处理对骨髓纤维化患者同种异体干细胞移植后的预后无负面影响。
IntroductionRuxolitinib is the first approved drug for treatment of myelofibrosis, but its impact of outcome after allogeneic stem cell transplantation (ASCT) is unknown.Patients and methodsWe reported on 159 myelofibrosis patients (pts) with a median age of 59years (r: 28-74) who received reduced intensity ASCT between 2000 and 2015 in eight German centers from related (n=23), matched (n=86) or mismatched (n=50) unrelated donors. Forty-six (29%) patients received ruxolitinib at any time point prior to ASCT. The median daily dose of ruxolitinib was 30mg (range 10-40mg) and the median duration of treatment was 4.9months (range 0.4-39.1months).ResultsPrimary graft failure was seen in 2 pts (4%) in the ruxolitinib and 3 (2%) in the non-ruxolitinib group. Engraftment and incidence of acute GVHD grade II to IV and III/IV did not differ between groups (37% vs 39% and 19% vs 28%, respectively), nor did the non-relapse mortality at 2years (23% vs 23%). A trend for lower risk of relapse was seen in the ruxolitinib group (9% vs 17%, P=.2), resulting in a similar 2year DFS and OS (68% vs 60% and 73% vs 70%, respectively). No difference in any outcome variable could be seen between ruxolitinib responders and those who failed or lost response to ruxolitinib.ConclusionsThese results suggest that ruxolitinib pretreatment in myelofibrosis patient does not negatively influence outcome after allogeneic stem cell transplantation.