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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
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.
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Submitted on : Friday, April 1, 2022 - 11:21:52 PM
Last modification on : Tuesday, May 24, 2022 - 3:21:33 AM

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Nicolaus Kröger, Giulia Sbianchi, Tiarlan Sirait, Christine Wolschke, Dietrich Beelen, et al.. 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. Leukemia, Nature Publishing Group: Open Access Hybrid Model Option B, 2021, 35 (12), pp.3551-3560. ⟨10.1038/s41375-021-01276-4⟩. ⟨hal-03628341⟩

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