Splenectomy before allogeneic hematopoietic cell transplantation for myelofibrosis: a French nationwide study.
Fiche publication
Date publication
octobre 2020
Journal
American journal of hematology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RUBIO Marie Thérèse
Tous les auteurs :
Bossard JB, Beuscart JB, Robin M, Mohty M, Barraco F, Chevallier P, Marchand T, Rubio MT, Charbonnier A, Blaise D, Bay JO, Botella-Garcia C, Damaj G, Beckerich F, Ceballos P, Cluzeau T, Cornillon J, Meunier M, Orvain C, Duhamel A, Garnier F, Kiladjian JJ, Yakoub-Agha I,
Lien Pubmed
Résumé
The value of pretransplant splenectomy in patients with myelofibrosis (MF) is subject to debate, since the procedure may preclude subsequent allogeneic hematopoietic cell transplantation (allo-HCT). To determine the impact of pretransplant splenectomy on the incidence of allo-HCT, we conducted a comprehensive retrospective study of all patients with MF for whom an unrelated donor search had been initiated via the French bone marrow transplantation registry (RFGM) between January 1 , 2008, and January 1 , 2017. Additional data were collected from the patients' medical files and a database held by the French-Language Society for Bone Marrow Transplantation and Cell Therapy (SFGM-TC). We used a multistate model with four states ("RFGM registration"; "Splenectomy"; "Death before allo-HCT", and "Allo-HCT") to evaluate the association between splenectomy and the incidence of allo-HCT. The study included 530 patients from 57 centers. With a median follow-up time of 6 years, we observed 81 splenectomies, 99 deaths before allo-HCT (90 without splenectomy and 9 after), and 333 allo-HCTs (268 without splenectomy and 65 after). In a bivariable analysis, the hazard ratio [95% confidence interval (CI)] for the association of splenectomy with allo-HCT was 7.2 [5.1-10.3] in the first 4 months and 1.18 [0.69-2.03] thereafter. The hazard ratio [95%CI] for death associated with splenectomy was 1.58 [0.79-3.14]. These reassuring results suggest that splenectomy does not preclude allo-HCT in patients with MF. This article is protected by copyright. All rights reserved.
Référence
Am J Hematol. 2020 Oct 27;: