Important Safety Data Evaluated in Meta-Analysis of 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%.