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Spleen volume and length determined by computed tomography impact outcome after allogeneic stem cell transplantation for myelofibrosis

Bone Marrow Transplantation volume 58, pages 755–761 (2023)Cite this article

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Abstract

Splenomegaly is a hallmark of myelofibrosis (MF), and reports on the impact of spleen size on the outcome of allo-HSCT have been conflicting, possibly due to differences in methods of assessment. We retrospectively analysed the impact of spleen volume and length measured by computed tomography on allo-HSCT outcome in 93 patients, 74% of whom had prior ruxolitinib treatment. Median spleen volume and length were 1.58 dm3 and 20 cm, respectively. We found a strong correlation between spleen volume and length (Pearson’s r = 0.95, p < 0.001), Spearman (rho = 0.96, p < 0.001). After a median follow-up of 41.7 months, 5-year overall and disease-free survival were 66% and 59%, respectively. Spleen size did not impact overall survival or non-relapse mortality. Larger spleen volume and length as continuous variables were associated with slower platelet and leucocyte engraftment and a higher risk of disease relapse in univariate and multivariate analyses. Spleen length measured precisely by imaging is a good surrogate for spleen volume. In the era of JAK inhibitors, larger spleen size reflects advanced disease in MF and is associated with an increased risk of relapse but has no impact on non-relapse mortality and overall survival after allo-HSCT.

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Fig. 1: Cumulative incidence of relapse and NRM according to spleen length.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are grateful to our patients and their families for their trust and support. We thank the staff of the BMT wards for taking care of our patients and the technicians of the BMT laboratories and radiology department for excellent technical assistance.

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  1. These authors contributed equally: Marlene Luther, Frank Oliver Henes.

Authors and Affiliations

  1. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Marlene Luther, Tatjana Zabelina, Radwan Massoud, Dietlinde Janson, Christine Wolschke, Evgeny Klyuchnikov, Nico Gagelmann, Boris Fehse, Nicolaus Kröger & Francis Ayuk

  2. Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Frank Oliver Henes & Gerhard Adam

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  1. Marlene Luther
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Contributions

ML, FOH, NK, and FA did the study conception. ML, RM, DJ, BF, and CW collected data. TZ, FOH, EK, and FA analysed data. ML, FOH, and FA wrote the manuscript. All authors interpreted data, reviewed, and corrected the manuscript.

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Correspondence to Francis Ayuk.

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Luther, M., Henes, F.O., Zabelina, T. et al. Spleen volume and length determined by computed tomography impact outcome after allogeneic stem cell transplantation for myelofibrosis. Bone Marrow Transplant 58, 755–761 (2023). https://doi.org/10.1038/s41409-023-01968-8

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