Many Myelofibrosis Patients Undergoing Transplantation Experience Poor Graft Function

A significant proportion of patients with myelofibrosis (MF) undergoing hematopoietic stem cell transplantation (HSCT) experience poor graft function, according to a study presented at the 65th ASH Annual Meeting & Exposition.

While HSCT is considered the sole curative option, “patients with MF often experience graft function impairment despite successful engraftment and absence of relapse signs,” the investigators wrote. “Although it has been reported that poor graft function can have a negative impact on the outcomes of patients with MF after HSCT, the specific factors that can influence poor graft function are not yet clearly understood.”

Daehun Kwag and colleagues analyzed clinical and immunological factors that may contribute to poor graft function (death, relapse, graft failure, and loss of chimerism as competing risks) and evaluated which pre-HSCT factors have significant impact on poor graft function after HSCT following transplantation. Their study comprised 93 patients (median age, 57 years; 55.9% men) who underwent HSCT for the treatment of MF between 2000 and 2022.

The study showed that poor graft function after 5 years from HSCT was 32% (95% CI, 23.4-42.7). Infused CD34 (+) cell dose and the presence of splenomegaly before HSCT had an impact on the occurrence of poor graft function after HSCT. The investigators noted that the other significant factor linked with poor graft function was ABO mismatch, with a substantial difference between matched patients and patients with bidirectional ABO mismatch.

“Further research is warranted to investigate the impact of poor graft function caused by these factors on outcomes such as transfusion requirements and quality of life,” the researchers concluded.

Reference

Kwag D, Min G, Park S, et al. Clinical and immunological factors associated with poor graft function after allogeneic hematopoietic stem cell transplantation in myelofibrosis patients. Abstract #1822. Presented at the 65th ASH Annual Meeting & Exposition; December 9-12, 2023; San Diego, California.