Work

Leukemic Transformation of Philadelphia-Negative Myeloproliferative Neoplasms: Results of a Treatment Algorithm Employing Allogeneic Transplantation Using Related and Unrelated Donors

Year: 2012

Type: article

Abstract: relapse.Five pts have died (median 9 months), 2 from graft-versushost disease (GVHD), 2 infections, and 1 elected Hospice care after experiencing renal failure.Last disease responses were complete remission (n 5 8), partial remission (n 5 6), stable disease (n 5 5), notevaluated (n 5 1).The incidences of grades II and III-IV acute GVHD were 60% and 15% respectively, and chronic GVHD was 46% at 1-year.Estimated 1-year rate of non-relapse mortality (NRM), relapse, progression-free (PFS), and overall survivals (OS) were 33%, 0%, 67%, and 67% respectively.Patients receiving peri-HCT rituximab had lower HR for relapse (HR:0, p 5 0.001), comparable HR for NRM (HR:1, p 5 0.9) and OS (HR:0.7,p 5 0.45), and a trend for lower HR for PFS (HR:0.5, p 5 0.07) compared to the historical control group.At day 84, median CD3 chimerisms were 99% vs 95% (p 5 0.08), respectively.After adjusting for the previous 4 significant covariates, PFS was better (HR:0.4,p 5 0.04) among the rituximab group.Peritransplant rituximab is a promising addition to nonmyeloablative HCT and may decrease early disease progression by allowing the generation of potent GVL effects.

Source: Transplantation and Cellular Therapy

DOI: 10.1016/j.bbmt.2011.12.506