Indications for and current results with allogeneic hematopoietic cell transplantation in patients with myelofibrosis.

摘要

We enjoyed the recent authoritative review by Dr Tefferi on current management of patients with myelofibrosis. The article provides guidance for hematologists and oncologists in both academic settings and community-based practices. We would like to complement those recommendations by adding information on recent developments in allogeneic hematopoietic cell transplantation (HCT), at present the only therapeutic modality that offers the potential of cure.The figures quoted in the article include nonrelapse mortality rates of 27% to 50%, overall survival at 3 to 5 years of 35% to 44%, and relapse-free survival of 17% to 51%. However, more recent results from our center in more than 100 patients with myelofibrosis, aged 18-70 years, show a day 100 mortality of 13%, a relapse incidence of 11%, and a 7-year actuarial survival of 61% for HLA-matched related and unrelated transplants. An analysis restricted to patients treated with "modem" conditioning regimens, such as busulfan (BU) with dose adjustments (targeted BU), in combination with cyclophosphamide or fludarabine, shows a 7-year survival of 68% overall, and 77% for patients with antecedent essential thrombocythemia or polycythemia vera.