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Blood, 15 March 2002, Vol. 99, No. 6, pp. 2255-2258
BRIEF REPORT
Allogeneic blood cell transplantation following reduced-intensity
conditioning is effective therapy for older patients with myelofibrosis
with myeloid metaplasia
Steven M. Devine,
Ron Hoffman,
Amit Verma,
Rajul Shah,
Basil A. Bradlow,
Wendy Stock,
Vera Maynard,
Ellen Jessop,
David Peace,
Marianne Huml,
Deana Thomason,
Yi-Hsiang Chen, and
Koen van
Besien
From the Blood and Marrow Transplantation Program,
Section of Hematology/Oncology, University of Illinois College of
Medicine, Chicago, IL
Standard myeloablative conditioning prior to allogeneic
hematopoietic stem cell (HSC) transplantation has been associated with
significant toxicity in patients older than 45 years of age with
myelofibrosis with myeloid metaplasia (MMM). We sought to evaluate the
efficacy of a reduced-intensity conditioning regimen for allogeneic
HSC transplantation in this setting. A regimen consisting of
fludarabine (30 mg/m2 intravenously daily for 5 days) and
melphalan (70 mg/m2 intravenously daily for 2 days)
followed by transplantation of filgrastim-mobilized peripheral blood
cells from HLA-identical siblings was administered to 4 older patients
(median age, 56 years; range, 48-58 years) with advanced MMM. All
patients achieved prompt neutrophil and platelet engraftment and have
experienced a significant regression of splenomegaly and bone marrow
fibrosis. All now have normal bone marrow cellularity. With a median
follow-up of 13 months (range, 11-19 months), all 4 patients are alive
with stable full-donor hematopoietic chimerism. These results support the feasibility and effectiveness of reduced-intensity conditioning prior to allogeneic HSC transplantation for older patients with advanced MMM.
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