Splenic irradiation before allogeneic stem cell transplantation for myelofibrosis

Journal Article · Fri Feb 15 04:00:00 EST 2019 · Medical Oncology (Online)

DOI:https://doi.org/10.1007/S12032-019-1245-5· OSTI ID:22938442

Helbig, Grzegorz; Wieczorkiewicz-Kabut, Agata; Markiewicz, Mirosław; Krzemień, Helena ^[1]; Wójciak, Michał ^[2]; Białas, Krzysztof; Kopera, Małgorzata; Rzenno, Ewa; Woźniczka, Krzysztof; Kopińska, Anna; Grygoruk-Wiśniowska, Iwona; Koclęga, Anna ^[1]

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1. Medical University of Silesia, Department of Hematology and Bone Marrow Transplantation, School of Medicine in Katowice (Poland)
2. Medical University of Warsaw, Students’ Research Group (Poland)

Splenectomy before allogeneic stem cell transplantation (ASCT) for patients with myelofibrosis (MF) remains a matter of debate, and conflicting results have been reported to date. The procedure seems to fasten post-transplant hematological recovery, but it does not have an impact on survival. The role of pre-transplant splenic irradiation (SI) is much more difficult to evaluate. Forty-four patients (25 males and 19 females) with MF at median age of 49 years at diagnosis (range 14–67) underwent ASCT. The post-transplant outcome was compared between irradiated and non-irradiated patients. Eleven patients received irradiation before transplantation. Median dose of radiation was 1000 cGy (range 600–2400). There was no difference in median time to engraftment between patients with and without previous radiotherapy. Acute and chronic graft versus host disease (GVHD) occurred in 47% and 36% of patients, respectively. There was no difference in GVHD incidence between groups. Eight patients relapsed/progressed in irradiated group versus 17 in non-irradiated (70% vs. 51%; p = 0.3). Transformation to acute myeloid leukemia was observed in 3 patients: 2 in irradiated and 1 in non-irradiated group. In total, 22 patients died with no statistical difference in death rate between irradiated and non-irradiated subjects. The probability of overall survival after transplant for the entire cohort at 2 years was 54% (72% for irradiated and 48% for non-irradiated patients; p = 0.25). Splenic irradiation prior to ASCT for myelofibrosis has not beneficial effect on post-transplant outcome.

• OSTI ID: 22938442
• Journal Information: Medical Oncology (Online), Journal Name: Medical Oncology (Online) Journal Issue: 2 Vol. 36; ISSN 1559-131X
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DIAGNOSIS
IRRADIATION
MYELOID LEUKEMIA
PATIENTS
RADIOTHERAPY
SPLENECTOMY
SPLENOMEGALY
STEM CELLS