Scientific publications

Transplantation for myelofibrosis patients in the ruxolitinib era: a registry study from the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire

Mar 21, 2024 | Magazine: Bone Marrow Transplantation

Sara Villar  1   2 , Sylvie Chevret  3 , Xavier Poire  4 , Magalie Joris  5 , Patrice Chevallier  6 , Jean-Henri Bourhis  7 , Edouard Forcade  8 , Sylvain Chantepie  9 , David Beauvais  10 , Nicole Raus  11 , Jacques-Olivier Bay  12 , Michael Loschi  13 , Raynier Devillier  14 , Remy Duléry  15 , Patrice Ceballos  16 , Marie Thérèse Rubio  17   18 , Sophie Servais  19 , Stephanie Nguyen  20 , Marie Robin  21


In this SFGM-TC registry study, we report the results after stem cell transplantation (HSCT) in 305 myelofibrosis patients, in order to determine potential risk factors associated with outcomes, especially regarding previous treatment with ruxolitinib. A total of 102 patients were transplanted from an HLA-matched-sibling donor (MSD), and 143 patients received ruxolitinib. In contrast with previous studies, our results showed significantly worse outcomes for ruxolitinib patients regarding overall survival (OS) and non-relapse mortality (NRM), especially in the context of unrelated donors (URD).

When exploring reasons for potential confounders regarding the ruxolitinib effect, an interaction between the type of donor and the use of ATG was found, therefore subsequent analyses were performed separately for each type of donor. Multivariable analyses did not confirm a significant negative impact of ruxolitinib in transplantation outcomes. In the setting of URD, only age and Fludarabine-Melphalan (FM) conditioning were associated with increased NRM.

For MSD, only Karnoksfy <70% was associated with reduced OS. However, a propensity score analysis showed that ruxolitinib had a negative impact on OS but only in non-responding patients, consistent with previous data. To conclude, with all the precautions due to confounders and bias, ruxolitinib itself does not appear to increase mortality after HSCT.

CITATION  Bone Marrow Transplant. 2024 Mar 21.  doi: 10.1038/s41409-024-02268-5

Our authors

Dr. Sara Villar Fernández
Navarre headquarters