Article Dans Une Revue Blood Advances Année : 2025

Role of molecular alterations in transplantation decisions for patients with primary myelofibrosis

Nico Gagelmann
Lina Benajiba
Rachel Salit
Corentin Orvain
Thomas Schroeder
  • Fonction : Auteur
Claire Bories
  • Fonction : Auteur
Carmelo Gurnari
Anita Badbaran
  • Fonction : Auteur
Françoise Boyer
  • Fonction : Auteur
Simona Pagliuca
Christina Rautenberg
  • Fonction : Auteur
Suzanne Tavitian
  • Fonction : Auteur
Victoria Pangiota
  • Fonction : Auteur
Jean-Christophe Ianotto
Felicitas Thol
Emilie Cayssials
  • Fonction : Auteur
Michael Heuser
Marie-Thérèse Rubio
  • Fonction : Auteur
Bruno Cassinat
Rafael Daltro de Oliveira
Craig Sauter
  • Fonction : Auteur
Jaroslaw Maciejewski
  • Fonction : Auteur
Hans Christian Reinhardt
  • Fonction : Auteur
Bart Scott
Valérie Ugo
Nicolaus Kröger
Jean-Jacques Kiladjian
Marie Robin

Résumé

Abstract The aim of our study was to analyze the potential survival benefit associated with hematopoietic stem cell transplantation (HSCT) according to clinicobiological scores, which incorporate mutation-enhanced international prognostic score system (MIPSS) to facilitate decision-making in this context. One transplant (n = 241) and 1 nontransplant cohort (n = 239) were used to test the hypothesis that patients with primary myelofibrosis with higher risk molecular score benefit from HSCT. A weighted propensity score was applied to balance confounding factors with the transplanted cohort as reference. Weighted Cox proportional hazard models and logistic regression analyses were performed. Overall, 105 patients who did not receive transplant could be matched to the 239 patients who did receive transplants. HSCT was associated with a higher 6-year overall survival rate in intermediate-2 (60.1% vs 41.5%) and high-risk DIPSS patients (44.4% vs 6.55%), high-risk MIPSS70 (46.5% vs 23.9%), high-risk (73.2% vs 39.7%) or very high-risk MIPSS70+V2 (51.8% vs 24%). Patients with intermediate MIPSS70 scores have an advantage of survival with HSCT only when their myelofibrosis transplant scoring system (MTSS) were low or intermediate. Patients who received transplant had an increased mortality risk the first year, but a significant benefit with HSCT after the 1-year landmark was observed in higher risk patients. This study confirms that, similar to DIPSS, MIPSS70 and MIPSS70+V2 risk score in addition to MTSS can be used to determine which patients with primary myelofibrosis have survival benefit from HSCT over non-HSCT strategies.

Dates et versions

hal-05014311 , version 1 (31-03-2025)

Identifiants

Citer

Damien Luque Paz, Nico Gagelmann, Lina Benajiba, Jérémie Riou, Rachel Salit, et al.. Role of molecular alterations in transplantation decisions for patients with primary myelofibrosis. Blood Advances, 2025, 9 (4), pp.797-807. ⟨10.1182/bloodadvances.2024014368⟩. ⟨hal-05014311⟩
27 Consultations
0 Téléchargements

Altmetric

Partager

  • More