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Comparison of reduced intensity conditioning regimens used in patients undergoing hematopoietic stem cell transplantation for myelofibrosis

Bone Marrow Transplantation volume 54, pages 204–211 (2019)Cite this article

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Abstract

The aim of this study is to compare clinical outcomes of patients who underwent allogeneic stem cell transplantation (HCT) for myelofibrosis with reduced intensity conditioning (RIC) using either Busulfan Fludarabine (BuFlu), Fludarabine Bis-chlorethyl-nitroso-urea/ carmustine Melphalan (FBM) or Fludarabine Melphalan (FluMel) regimens. Sixty-one patients were identified who underwent HCT with one of these RIC regimens. Overall survival (OS) was not different in the 3 groups. However, 100% donor chimerism was seen in more frequently at day +30 and day +100 in patients who received FBM or FluMel than BuFlu, in both CD3 and CD33 fractions. For instance, 100% donor chimerism in CD33 fraction was present in 100% patients in FBM cohort, 90% in FluMel cohort while 44% in BuFlu cohort at day +100. Acute graft-versus host disease, grade 2–4 and grade 3–4, was not statistically different in the 3 groups (BuFlu 47 and 35%, FBM 68 and 27%, FluMel 68 and 46%; p = 0.31 and 0.45). Relapses and non-relapse mortality was also not statistically significantly different. Our study shows similar OS with these 3 RIC regimens in myelofibrosis; although donor chimerism at day +30 and day +100 was better in patients who received FBM and FluMel.

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Authors and Affiliations

  1. Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, USA

    Tania Jain, James L. Slack, Nandita Khera, Pierre Noel, Jose F. Leis, Lisa Z. Sproat & Jeanne Palmer

  2. Division of Biostatistics, Mayo Clinic, Scottsdale, AZ, USA

    Katie L. Kunze & M’hamed Temkit

  3. Division of Palliative Care and Geriatric Medicine, Dana Farber Cancer Institute and Brigham and Women’s Hospital, Boston, MA, USA

    Daniel K. Partain

  4. Division of Hematology and Medical Oncology, Mayo Clinic, Rochester, MN, USA

    Mrinal S. Patnaik & William J. Hogan

  5. Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA

    Vivek Roy

  6. Honor Health Cancer Care Network, Scottsdale, AZ, USA

    Veena Fauble

  7. University of Texas Health San Antonio Cancer Center, San Antonio, TX, USA

    Ruben A. Mesa

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  1. Tania Jain
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Contributions

Author contribution:

TJ: Conceptualization, data acquisition, interpretation of results, writing—drafting the manuscript, reviewing and editing of manuscript and approved the final version. KLK and MT: Formal analysis, editing and reviewing of manuscript. DKP: Data acquisition. MSP, JLS, NK, WJH, VR, PN, JFL, LZS, VF, RAM: Writing—reviewing and editing of manuscript and approved the final version. JP: conceptualization, supervision, interpretation of results, reviewing and editing of manuscript and approved the final version.

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Correspondence to Tania Jain.

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Conflict of interest

RAM—Consultant: Novartis, Ariad, Galena; Research Support: Incyte, Gilead, CTI, Promedior, Celgene; The remaining authors declare that they have no conflict of interest.

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Jain, T., Kunze, K.L., Temkit, M. et al. Comparison of reduced intensity conditioning regimens used in patients undergoing hematopoietic stem cell transplantation for myelofibrosis. Bone Marrow Transplant 54, 204–211 (2019). https://doi.org/10.1038/s41409-018-0226-1

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