Jan Philipp Bewersdorf, MD, discusses the safety outcomes of a systematic review and meta-analysis of 43 studies investigating efficacy and safety of allogeneic hematopoietic cell transplant in 8739 patients with primary or secondary myelofibrosis.
Jan Philipp Bewersdorf, MD, hospital resident, Yale University School of Medicine, discusses the safety outcomes of a systematic review and meta-analysis of 43 studies investigating efficacy and safety of allogeneic hematopoietic cell transplant (allo-HCT) in 8739 patients with primary or secondary myelofibrosis.
The safety outcomes looked in this analysis were non-relapse mortality and graft-vs-host disease (GVHD). For Bewersdorf, these were some of the main findings from the analysis because these data will help counsel patients. The rate of non-relapse mortality was 25.9% at 1 year, which is significant. That percentage increased slightly over time, but most transplant-related mortality occurs in the first year after allo-HCT. The non-relapse mortality was 30.5% at 5 years.
Primary graft failure was observed in 7% of patients, which Bewersdorf says is higher than other disease types in which allo-HCT is used like acute myeloid leukemia. Although GVHD is a less severe issue than death, it is still significant for the patient’s quality of life, considering their time in the hospital and healthcare expenses. There were 44.0% of patients who experienced acute GVHD across all severity grades. This included grade 2 skin GVHD, which Bewersdorf feels is probably manageable, as well as grade 3 or 4 acute GVHD in 15.2%. The incidence of chronic GVHD was 46.5%.