Canterbury DHB
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When considering the decision whether or not to recommend allogeneic transplantation the benefits, risks and alternative treatments must be considered as well as the natural history of PMF if untreated. Various risk scores have been devised including the dynamic IPSS (DIPSS) and the DIPSS-plus.
Transplant-eligible patients <45 years with an IPSS of int-2 or high, especially with transfusion dependence and/or adverse cytogenetics should be considered for conventional myeloablative SCT
Transplant-eligible patients >45 years with an IPSS of int-2 or high, especially with transfusion dependence and/or adverse cytogenetics, and an HSCT-CI ≥3 should be considered for reduced intensity SCT
Outcomes vary greatly between centres but for example, in the CIBMTR registry of 289 patients transplanted between 1989-2002, median age 47 years (18-73) the 100-day TRM was 18% for MSD, 35% for MUD and 19% for MMUD. 5-year OS was 37%, 30% and 40% respectively.
See Primary Myelofibrosis (PMF) in the MPD section.
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Topic Code: 10193
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