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Incidence and risk factors for graft failure after allogeneic hematopoietic stem cell transplantation in patients with myelofibrosis

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机构: [1]Peking University People’s Hospital, Beijing, China. [2]Shanghai Zhaxin Hospital, Shanghai, China. [3]The First Affiliated Hospital of Soochow University, Suzhou, China. [4]Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, Tianjin, China. [5]West China Hospital, Sichuan University, Chengdu, China. [6]The First Affiliated Hospital, Zhejiang University, Hangzhou, China. [7]Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [8]Chongqing Xinqiao Hospital, Chongqing, China. [9]The 960th Hospital of the People’s Liberation Army, Jinan, China. [10]Tianjin First Central Hospital, Tianjin, China. [11]The Second Affiliated Hospital of Dalian Medical University, Dalian, China. [12]The First Hospital of Jilin University, Changchun, China. [13]Southwest Hospital, Army Medical University, Chongqing, China. [14]Tai’an Central Hospital, Tai’an, China. [15]The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. [16]Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [17]Aerospace Center Hospital, Beijing, China. [18]Henan Cancer Hospital, Zhengzhou, China. [19]The 920th Hospital of the People’s Liberation Army, Kuming, China. [20]Affiliated Hospital of Guizhou Medical University, Guiyang, China. [21]Jiangsu Province Hospital, Nanjing, China. [22]Ningbo University Affiliated People’s Hospital, Ningbo, China. [23]Air Force Medical Center, Beijing, China. [24]Affiliated Hospital of Xuzhou Medical University, Xuzhou, China. [25]The First Medical Center of the People’s Liberation Army, Beijing, China. [26]Guangxi Zhuang Autonomous Region People’s Hospital, Nanning, China. [27]Guangzhou First People’s Hospital, Guangzhou, China. [28]Institute of Hematology, Harbin Medical University, Harbin, China. [29]General Hospital of Western Theater Command of the Chinese People’s Liberation Army, Chengdu, China. [30]The First Affiliated Hospital of Xinjiang Medical University, Wulumuqi, China. [31]Shandong Provincial Hospital, Jinan, China. [32]Affiliated Hospital of Jining Medical College, Jining, China.
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Graft failure (GF) is a barrier to successful allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelofibrosis (MF). We investigated the incidence, risk factors, and prognosis for GF after allo-HSCT for MF. Two hundred and eleven patients with MF who underwent allo-HSCT across 32 hematology centers in China between December 2008 and December 2024 were retrospectively analyzed. Among them, 66 underwent matched sibling donor HSCT, 127 haploidentical HSCT, and 18 unrelated donor HSCT. The overall GF incidence was 12.5%. GF incidence was significantly associated with donor type (matched sibling, 4.8%; alternative, 13.3%; P = 0.024). Pretransplant massive splenomegaly increased GF incidence (non-massive splenomegaly, 8.5%; massive, 18.5%; P = 0.034). In multivariate analysis, massive splenomegaly (HR = 3.047; P = 0.007) and alternative donors (HR = 3.528; P = 0.041) increased GF risk. With median follow-up of 734 days, 3-year OS, DFS, relapse rate and NRM was 65.5%, 60.8%, 10.1% and 27.8%, respectively. Multivariate analysis showed pretransplant splenomegaly reduced 3-year DFS (HR = 1.671; P = 0.025), and alternative donors reduced 3-year OS (HR = 2.033; P = 0.015). In conclusion, Allo-HSCT provides curative outcomes for MF patients. However, GF remains a significant challenge, particularly in haploidentical HSCT and those with massive pretransplant splenomegaly.© 2025. The Author(s), under exclusive licence to Springer Nature Limited.

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出版当年[2025]版:
大类 | 2 区 医学
小类 | 2 区 血液学 2 区 免疫学 2 区 移植 3 区 肿瘤学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 血液学 2 区 免疫学 2 区 移植 3 区 肿瘤学
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第一作者机构: [1]Peking University People’s Hospital, Beijing, China.
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