Impact of ruxolitinib pretreatment on outcomes after allogeneic stem cell transplantation in patients with myelofibrosis

Shahnaz Syed Abd Kadir S 1 , Christopeit M 1 , Wulf G 2 , Wagner E 3 , Bornhauser M 4 , Schroeder T 5 Show all authors , Crysandt M 6 , Mayer K 7 , Jonas J 7 , Stelljes M 8 , Badbaran A 1 , Ayuketang Ayuk F 1 , Triviai I 1 , Wolf D 7 , Wolschke C 1 , Kröger N 1

Affiliations 

  • 1 Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • 2 Department of Hematology/Oncology, University Hospital Göttingen, Göttingen, Germany
  • 3 Department for Hematology and Oncology, University Hospital Mainz, Mainz, Germany
  • 4 Department for Hematology and Oncology, University Hospital Dresden, Dresden, Germany
  • 5 Department for Hematology, Oncology and Clinical Immunology, University Hospital Duesseldorf, Düsseldorf, Germany
  • 6 Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
  • 7 Medical Clinic 3, Oncology, Hematology, Immunoncology and Rheumatology, University Clinic Bonn (UKB), Bonn, Germany
  • 8 Department of Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany
Eur J Haematol, 2018 Sep;101(3):305-317.
PMID: 29791053 DOI: 10.1111/ejh.13099

Abstract

INTRODUCTION: Ruxolitinib is the first approved drug for treatment of myelofibrosis, but its impact of outcome after allogeneic stem cell transplantation (ASCT) is unknown.
PATIENTS AND METHODS: We reported on 159 myelofibrosis patients (pts) with a median age of 59 years (r: 28-74) who received reduced intensity ASCT between 2000 and 2015 in eight German centers from related (n = 23), matched (n = 86) or mismatched (n = 50) unrelated donors. Forty-six (29%) patients received ruxolitinib at any time point prior to ASCT. The median daily dose of ruxolitinib was 30 mg (range 10-40 mg) and the median duration of treatment was 4.9 months (range 0.4-39.1 months).
RESULTS: Primary graft failure was seen in 2 pts (4%) in the ruxolitinib and 3 (2%) in the non-ruxolitinib group. Engraftment and incidence of acute GVHD grade II to IV and III/IV did not differ between groups (37% vs 39% and 19% vs 28%, respectively), nor did the non-relapse mortality at 2 years (23% vs 23%). A trend for lower risk of relapse was seen in the ruxolitinib group (9% vs 17%, P = .2), resulting in a similar 2 year DFS and OS (68% vs 60% and 73% vs 70%, respectively). No difference in any outcome variable could be seen between ruxolitinib responders and those who failed or lost response to ruxolitinib.
CONCLUSIONS: These results suggest that ruxolitinib pretreatment in myelofibrosis patient does not negatively influence outcome after allogeneic stem cell transplantation.
Study site: 8 health clinics in Germany

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