The impact of bone marrow fibrosis on the outcome of hematopoietic stem cell transplantation

Transplant Proc. 2010 Sep;42(7):2713-9. doi: 10.1016/j.transproceed.2010.05.150.

Abstract

We retrospectively analyzed the data of 175 patients who underwent autologous (n = 69) or allogeneic hematopoietic stem cell transplantation (HCT) (n = 106) including 19 (27.5%) and 38 (35.8%) recipients who had bone marrow fibrosis (BMF) prior to transplantation, respectively. We investigated the effects of BMF on engraftment, graft-versus-host disease (GVHD), early posttransplant complications, and survival. Pretransplantation BMF did not delay engraftment and showed no impact either on early posttransplant complications or on the development of acute and/or chronic GVHD. Probability of 1-year overall survival (OS) and progression-free survival (PFS) of autologous HCT recipients were similar, namely 76.7% versus 88.6% (P > .005) and 26.33% versus 16.5% (P > .05) among patients with versus without fibrosis, respectively. In allogeneic HCT recipients, the probability of 1-year OS was 35.2% among patients with versus 48.9% among those without fibrosis (P = .004) PFS at 1 year was inferior among allogeneic HCT recipients with BMF: 27.8% versus 51.2% (P = .0008). Cox regression analysis revealed BMF to be independently associated with age, Sorror comorbidity index, primary disease, and disease status during HCT (P = .045).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Graft vs Host Disease / epidemiology
  • HLA Antigens / immunology
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / surgery
  • Primary Myelofibrosis / surgery*
  • Retrospective Studies
  • Transplantation Conditioning / methods
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • HLA Antigens