TY - JOUR
T1 - Allogeneic Hemopoietic Stem Cell Transplantation for Myelofibrosis: 2021
AU - Bacigalupo, Andrea
AU - Innocenti, Idanna
AU - Rossi, Elena
AU - Sora', Federica
AU - Galli, Eugenio
AU - Autore, Francesco
AU - Metafuni, Elisabetta
AU - Chiusolo, Patrizia
AU - Giammarco, Sabrina
AU - Laurenti, Luca
AU - Benintende, Giulia
AU - Sica, Simona
AU - De Stefano, Valerio
PY - 2022
Y1 - 2022
N2 - The aim of this review is to update the current status of allogeneic hemopoietic stem cell transplants (HSCT) for patients with myelofibrosis (MF). We have first summarized the issue of an indication for allogeneic HSCT, discussing several prognostic scoring systems, developed to predict the outcome of MF, and therefore to identify patients who will benefit of an allogeneic HSCT. Patients with low risk MF are usually not selected for a transplant, whereas patients with intermediate or high risk MF are eligible. A separate issue, is how to predict the outcome of HSCT: we will outline a clinical molecular myelofibrosis transplant scoring system (MTSS), which predicts overall survival, ranging from 90% for low risk patients, to 20% for very high risk patients. We will also discuss transfusion burden and spleen size, as predictors of transplant outcome. The choice of a transplant platform including the conditioning regimen, the stem cell source and GvHD prophylaxis, are crucial for a successful program in MF, and will be outlined. Complications such as poor graft function, graft failure, GvHD and relapse of the disease, will also be reviewed. Finally we discuss monitoring the disease after HSCT with donor chimerism, driver mutations and hematologic data. We have made an effort to make this review as comprehensive and up to date as possible, and we hope it will provide some useful data for the clinicians.
AB - The aim of this review is to update the current status of allogeneic hemopoietic stem cell transplants (HSCT) for patients with myelofibrosis (MF). We have first summarized the issue of an indication for allogeneic HSCT, discussing several prognostic scoring systems, developed to predict the outcome of MF, and therefore to identify patients who will benefit of an allogeneic HSCT. Patients with low risk MF are usually not selected for a transplant, whereas patients with intermediate or high risk MF are eligible. A separate issue, is how to predict the outcome of HSCT: we will outline a clinical molecular myelofibrosis transplant scoring system (MTSS), which predicts overall survival, ranging from 90% for low risk patients, to 20% for very high risk patients. We will also discuss transfusion burden and spleen size, as predictors of transplant outcome. The choice of a transplant platform including the conditioning regimen, the stem cell source and GvHD prophylaxis, are crucial for a successful program in MF, and will be outlined. Complications such as poor graft function, graft failure, GvHD and relapse of the disease, will also be reviewed. Finally we discuss monitoring the disease after HSCT with donor chimerism, driver mutations and hematologic data. We have made an effort to make this review as comprehensive and up to date as possible, and we hope it will provide some useful data for the clinicians.
KW - allogeneic transplantation
KW - busulfan
KW - fludarabine chimerism
KW - myelofibrosis
KW - splenectomy
KW - thiotepa
KW - allogeneic transplantation
KW - busulfan
KW - fludarabine chimerism
KW - myelofibrosis
KW - splenectomy
KW - thiotepa
UR - http://hdl.handle.net/10807/184843
U2 - 10.3389/fimmu.2021.637512
DO - 10.3389/fimmu.2021.637512
M3 - Article
SN - 1664-3224
VL - 12
SP - N/A-N/A
JO - Frontiers in Immunology
JF - Frontiers in Immunology
ER -