Abstract
Myelofibrosis (MF) is a disease of elderly with median age of 65years at diagnosis. Allogeneic stem cell transplantation (ASCT) currently is the only potentially curative option, although associated with treatment-related morbidity and mortality. Development of reduced intensity conditioning (RIC) regimens enabled transplant to be performed successfully in older patients. To evaluate outcome of transplantation among elderly patients (≥65years), we conducted retrospective analysis of results in 45 patients transplanted between 2002 and 2018 at the University Medical Center Hamburg. Median age at ASCT was 67years (r: 65-74). The majority of patients (n=43) received busulfan plus fludarabine RIC regimen and were classified as DIPSS intermediate-2 or high risk at time of transplantation. After a median follow-up of 4years, 6-year estimated progression-free survival and overall survival were 60% and 64%, respectively. Cumulative incidence of non-relapse mortality was 21% at 1year. Cumulative incidence of relapse at 6years was 10%. Patients with Sorror score 3 or less had a significant better survival (73% vs 25%, P=.009). Reduced intensity conditioning regimen followed by ASCT in older patients with myelofibrosis is a curative treatment option. Outcome is more favorable in patients with no or minimal comorbidities.
Published Version
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