Allogeneic Hematopoietic Cell Transplantation for Advanced Polycythemia Vera and Essential Thrombocythemia

Karen K. Ballen, Ann E. Woolfrey, Xiaochun Zhu, Kwang Woo Ahn, Baldeep Wirk, Mukta Arora, Biju George, Bipin N. Savani, Brian Bolwell, David L. Porter, Ed Copelan, Gregory Hale, Harry C. Schouten, Ian Lewis, Jean Yves Cahn, Joerg Halter, Jorge Cortes, Matt E. Kalaycio, Joseph Antin, Mahmoud D. AljurfMatthew H. Carabasi, Mehdi Hamadani, Philip McCarthy, Steven Pavletic, Vikas Gupta, H. Joachim Deeg, Richard T. Maziarz, Mary M. Horowitz, Wael Saber

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Allogeneic hematopoietic cell transplantation (HCT) is curative for selected patients with advanced essential thrombocythemia (ET) or polycythemia vera (PV). From 1990 to 2007, 75 patients with ET (median age 49 years) and 42 patients with PV (median age 53 years) underwent transplantations at the Fred Hutchinson Cancer Research Center (FHCRC; n = 43) or at other Center for International Blood and Marrow Transplant Research (CIBMTR) centers (n = 74). Thirty-eight percent of the patients had splenomegaly and 28% had a prior splenectomy. Most patients (69% for ET and 67% for PV) received a myeloablative (MA) conditioning regimen. Cumulative incidence of neutrophil engraftment at 28 days was 88% for ET patients and 90% for PV patients. Acute graft-versus-host disease (aGVHD) grades II to IV occurred in 57% and 50% of ET and PV patients, respectively. The 1-year treatment-related mortality (TRM) was 27% for ET and 22% for PV. The 5-year cumulative incidence of relapse was 13% for ET and 30% for PV. Five-year survival/progression-free survival (PFS) was 55%/47% and 71%/48% for ET and PV, respectively. Patients without splenomegaly had faster neutrophil and platelet engraftment, but there were no differences in TRM, survival, or PFS. Presence of myelofibrosis (MF) did not affect engraftment or TRM. Over 45% of the patients who undergo transplantations for ET and PV experience long-term PFS.

Original languageEnglish (US)
Pages (from-to)1446-1454
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number9
DOIs
StatePublished - Sep 2012

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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