Impact of prior JAK-inhibitor therapy with ruxolitinib on outcome after allogeneic hematopoietic stem cell transplantation for myelofibrosis: a study of the CMWP of EBMT
Nicolaus Kröger
(1)
,
Giulia Sbianchi
(2)
,
Tiarlan Sirait
(3)
,
Christine Wolschke
(1)
,
Dietrich Beelen
,
Jakob Passweg
(4)
,
Marie Robin
(5)
,
Radovan Vrhovac
(6)
,
Grzegorz Helbig
(7)
,
Katja Sockel
(8)
,
Eibhlin Conneally
(9)
,
Marie-Thérèse Rubio
(10, 11)
,
Yves Beguin
(12)
,
Jürgen Finke
(13)
,
Paolo Bernasconi
(14)
,
Elena Morozova
(15)
,
Johannes Clausen
(16)
,
Peter von Dem Borne
(17)
,
Nicolaas Schaap
(18)
,
Wilfried Schroyens
(19)
,
Francesca Patriarca
(20)
,
Nicola Di Renzo
,
Zeynep Arzu Yeğin
(21)
,
Patrick Hayden
(22)
,
Donal Mclornan
(23)
,
Ibrahim Yakoub-Agha
(24)
1
UKE -
Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg]
2 Università degli Studi di Roma Tor Vergata [Roma]
3 EBMT Data Office Leiden [Leiden, TheNetherlands]
4 University Hospital Basel [Basel]
5 AP-HP - Hopital Saint-Louis [AP-HP]
6 University Hospital Centre Zagreb
7 SUM - Medical University of Silesia
8 University Hospital Carl Gustav Carus [Dresden, Germany]
9 St James's University Hospital
10 Service d'Hématologie [CHRU Nancy]
11 IMoPA - Ingénierie Moléculaire et Physiopathologie Articulaire
12 CHU-Liège - Centre Hospitalier Universitaire de Liège
13 University of Freiburg [Freiburg]
14 Fondazione IRCCS Policlinico San Matteo [Pavia]
15 Pavlov First Saint Petersburg State Medical University [St. Petersburg]
16 Ordensklinikum Linz Elisabethinen
17 Leiden University Medical Center (LUMC)
18 Radboud University Medical Center [Nijmegen]
19 UZA - Antwerp University Hospital [Edegem]
20 Università degli Studi di Udine - University of Udine [Italie]
21 Gazi University
22 Trinity College Dublin
23 Guy's Hospital [London]
24 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
2 Università degli Studi di Roma Tor Vergata [Roma]
3 EBMT Data Office Leiden [Leiden, TheNetherlands]
4 University Hospital Basel [Basel]
5 AP-HP - Hopital Saint-Louis [AP-HP]
6 University Hospital Centre Zagreb
7 SUM - Medical University of Silesia
8 University Hospital Carl Gustav Carus [Dresden, Germany]
9 St James's University Hospital
10 Service d'Hématologie [CHRU Nancy]
11 IMoPA - Ingénierie Moléculaire et Physiopathologie Articulaire
12 CHU-Liège - Centre Hospitalier Universitaire de Liège
13 University of Freiburg [Freiburg]
14 Fondazione IRCCS Policlinico San Matteo [Pavia]
15 Pavlov First Saint Petersburg State Medical University [St. Petersburg]
16 Ordensklinikum Linz Elisabethinen
17 Leiden University Medical Center (LUMC)
18 Radboud University Medical Center [Nijmegen]
19 UZA - Antwerp University Hospital [Edegem]
20 Università degli Studi di Udine - University of Udine [Italie]
21 Gazi University
22 Trinity College Dublin
23 Guy's Hospital [London]
24 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
Nicolaus Kröger
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- Function : Correspondent author
- PersonId : 871205
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Dietrich Beelen
- Function : Author
Marie Robin
- Function : Author
- PersonId : 803090
- ORCID : 0000-0003-1388-9876
Katja Sockel
- Function : Author
- PersonId : 824401
- ORCID : 0000-0003-1732-7299
Marie-Thérèse Rubio
- Function : Author
- PersonId : 19145
- IdHAL : marie-therese-rubio
- ORCID : 0000-0003-3732-5442
- IdRef : 149394489
Johannes Clausen
- Function : Author
- PersonId : 824176
- ORCID : 0000-0002-2729-9706
Nicola Di Renzo
- Function : Author
- PersonId : 824402
- ORCID : 0000-0003-0604-6934
Donal Mclornan
- Function : Author
- PersonId : 794436
- ORCID : 0000-0003-1224-091X
Ibrahim Yakoub-Agha
- Function : Author
- PersonId : 757624
- ORCID : 0000-0003-4524-8782
- IdRef : 069672504
Abstract
Abstract JAK1/2 inhibitor ruxolitinib (RUX) is approved in patients with myelofibrosis but the impact of pretreatment with RUX on outcome after allogeneic hematopoietic stem cell transplantation (HSCT) remains to be determined. We evaluated the impact of RUX on outcome in 551 myelofibrosis patients who received HSCT without ( n = 274) or with ( n = 277) RUX pretreatment. The overall leukocyte engraftment on day 45 was 92% and significantly higher in RUX responsive patients than those who had no or lost response to RUX (94% vs. 85%, p = 0.05). The 1-year non-relapse mortality was 22% without significant difference between the arms. In a multivariate analysis (MVA) RUX pretreated patients with ongoing spleen response at transplant had a significantly lower risk of relapse (8.1% vs. 19.1%; p = 0.04)] and better 2-year event-free survival (68.9% vs. 53.7%; p = 0.02) in comparison to patients without RUX pretreatment. For overall survival the only significant factors were age > 58 years ( p = 0.03) and HLA mismatch donor ( p = 0.001). RUX prior to HSCT did not negatively impact outcome after transplantation and patients with ongoing spleen response at time of transplantation had best outcome.