ArticleClinical lymphoma, myeloma & leukemia2026
Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation in Older Patients Aged 65 Years and Above With Myelofibrosis.
Article in Clinical lymphoma, myeloma & leukemia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAllogeneic hematopoietic stem cell transplantation (allo-HCT) remains the only curative option for myelofibrosis (MF) but is often underutilized in patients aged ≥ 65 due to concerns about treatment-related toxicity.
methodsWe conducted a retrospective analysis of chronic-phase MF allo-HCT recipients using the publicly available CIBMTR P-5640 dataset (2008-2019). Key endpoints included overall survival (OS), disease-free survival (DFS), relapse, nonrelapse mortality (NRM), and graft-vs-host disease (GVHD)-related outcomes. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models. Statistical analysis was performed using R (v4.3.2), with statistical significance defined as P < .05.
resultsWe included 856 MF allo-HCT recipients (aged ≥ 65: n = 259, aged < 65: n = 597). The 2-year OS, DFS, and GVHD-free, relapse-free survival (GRFS) for patients ≥ 65 years were 62%, 33%, and 12%, respectively. Rates of relapse, NRM, grade II-IV acute GVHD, and chronic GVHD were 43%, 27%, 46%, and 42%, respectively. In multivariable analysis, age ≥ 65 years was independently associated with inferior DFS (HR 1.26, 95% CI 1.03-1.55, P = .025); however, there was no impact on other post-transplant outcomes. Independent predictors of worse outcomes in older patients included splenic radiation and ATG use, secondary MF, higher comorbidities (HCT-CI ≥ 3), mismatched donor type, and bone marrow graft.
conclusionsIn myelofibrosis patients aged 65 years and above undergoing allogeneic HCT, a favorable 2-year overall survival of 62% was noted with an inferior DFS compared to younger patients, while other post-transplant outcomes remained comparable. These findings support allo-HCT as a viable option in selected elderly MF patients using tailored transplant strategies.
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