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EBMT 2026 | The risk of pulmonary complications in patients with myelofibrosis in the post-transplant setting
Rachel Salit, MD, Fred Hutchinson Cancer Center, Seattle, WA, provides insight into the risk of pulmonary complications, specifically bronchiolitis obliterans, following stem cell transplantation in patients with myelofibrosis (MF). Dr Salit emphasizes the importance of pulmonary monitoring in the post-transplant setting and suggests that patients could also be encouraged to take part in preventative spirometry tests using a home spirometer. This interview took place at the 52nd Annual Meeting of the EBMT in Madrid, Spain.
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Transcript
In our first study where we did ruxolitinib pre-transplants, one of the common causes of non-relapse mortality was pulmonary. So in 13 of our 60 patients that died, 12 of them were from pulmonary complications of some sort, whether that was pneumonia or respiratory failure. And so we thought to dig in more to what were the pulmonary issues specific to these patients...
In our first study where we did ruxolitinib pre-transplants, one of the common causes of non-relapse mortality was pulmonary. So in 13 of our 60 patients that died, 12 of them were from pulmonary complications of some sort, whether that was pneumonia or respiratory failure. And so we thought to dig in more to what were the pulmonary issues specific to these patients. There was a paper that was published looking at myelofibrosis patients who were not transplanted that showed that patients with myelofibrosis are at a two times higher risk of pulmonary complications, even longitudinally, even just a natural history study. So we looked at patients that had been transplanted to see what had happened in those patients in terms of pulmonary complications and specifically bronchiolitis obliterans. And we noted that there were a high percentage of patients that developed lung complications in those patients, with about a 15% incidence of bronchiolitis obliterans, which is much higher than is reported in the literature. Why that is, we’re not sure and needs some exploring, but one possibility is the extramedullary hematopoiesis in the lungs in patients with myelofibrosis. And so we’re increasing surveillance in those patients in terms of pulmonary function test monitoring. So patients are getting a three-month, six-month, a nine-month and one-year pulmonary function test post-transplant. We also have a preventative spirometry test where they can take home a home spirometer. And we’re trying to encourage patients to participate on that study.
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Disclosures
Clinical trial funding: Incyte.
