EBMT 2023 | The role of allogeneic transplantation in myelofibrosis & patient eligibility for alloSCT
Jean-Jacques Kiladjian, MD, PhD, Saint-Louis Hospital & Paris Diderot University, Paris, France, comments on the role of allogeneic stem cell transplantation (alloSCT) in myelofibrosis (MF). Prof. Kiladjian explains that due to the high toxicity of this procedure, it is important to carefully select eligible patients. In addition, it has recently been shown that sibling donor transplantation leads to better overall survival (OS) in the long-term than matched unrelated donor transplantation. This interview took place at the 49th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) held in Paris, France.
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Transcript (edited for clarity)
As of today, I think allogeneic transplant is still the only curative treatment for patients with myelofibrosis, although it concerns only a minority of patients. In fact, as the median age of diagnosis of this disease is quite old, about 60-65 years of age, few patients are eligible for transplantation. In addition, because of the high disease burden, especially inflammatory symptoms, cachexia, and often the patients at high risk have a very poor condition when they are diagnosed, and the risk of transplantation is too high...
As of today, I think allogeneic transplant is still the only curative treatment for patients with myelofibrosis, although it concerns only a minority of patients. In fact, as the median age of diagnosis of this disease is quite old, about 60-65 years of age, few patients are eligible for transplantation. In addition, because of the high disease burden, especially inflammatory symptoms, cachexia, and often the patients at high risk have a very poor condition when they are diagnosed, and the risk of transplantation is too high. However, once these patients are transplanted, for example, we perform a Phase II prospective study in France, the JAK ALLO study that showed that the overall survival on the long term after transplantation was very good, about around 80% for patients who had a sibling donor. However, for those patients who received transplantation with a matched unrelated donor, the overall survival dropped dramatically to below 50% after 2 to 3 years after transplantation. So, showing that although it may cure some patients, the indications have to be carefully waited and patients carefully selected to achieve this cure without increasing the risk of death.
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Disclosures
Advisory boards for Novartis, Abbvie, BMS, AOP Orphan.
