PMID- 26293647 OWN - NLM STAT- MEDLINE DCOM- 20160224 LR - 20181202 IS - 1476-5551 (Electronic) IS - 0887-6924 (Linking) VI - 29 IP - 11 DP - 2015 Nov TI - Indication and management of allogeneic stem cell transplantation in primary myelofibrosis: a consensus process by an EBMT/ELN international working group. PG - 2126-33 LID - 10.1038/leu.2015.233 [doi] AB - The aim of this work is to produce recommendations on the management of allogeneic stem cell transplantation (allo-SCT) in primary myelofibrosis (PMF). A comprehensive systematic review of articles released from 1999 to 2015 (January) was used as a source of scientific evidence. Recommendations were produced using a Delphi process involving a panel of 23 experts appointed by the European LeukemiaNet and European Blood and Marrow Transplantation Group. Key questions included patient selection, donor selection, pre-transplant management, conditioning regimen, post-transplant management, prevention and management of relapse after transplant. Patients with intermediate-2- or high-risk disease and age <70 years should be considered as candidates for allo-SCT. Patients with intermediate-1-risk disease and age <65 years should be considered as candidates if they present with either refractory, transfusion-dependent anemia, or a percentage of blasts in peripheral blood (PB) >2%, or adverse cytogenetics. Pre-transplant splenectomy should be decided on a case by case basis. Patients with intermediate-2- or high-risk disease lacking an human leukocyte antigen (HLA)-matched sibling or unrelated donor, should be enrolled in a protocol using HLA non-identical donors. PB was considered the most appropriate source of hematopoietic stem cells for HLA-matched sibling and unrelated donor transplants. The optimal intensity of the conditioning regimen still needs to be defined. Strategies such as discontinuation of immune-suppressive drugs, donor lymphocyte infusion or both were deemed appropriate to avoid clinical relapse. In conclusion, we provided consensus-based recommendations aimed to optimize allo-SCT in PMF. Unmet clinical needs were highlighted. FAU - Kroger, N M AU - Kroger NM AD - Department of Stem Cell Transplantation, University Hospital, Hamburg, Germany. FAU - Deeg, J H AU - Deeg JH AD - Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA. FAU - Olavarria, E AU - Olavarria E AD - Department of Hematology, Hospital of Navarra, Navarra Health Service, Pamplona, Spain. FAU - Niederwieser, D AU - Niederwieser D AD - Department of Haematology, Clinical Oncology and Hemostasiology, University of Leipzig, Leipzig, Germany. FAU - Bacigalupo, A AU - Bacigalupo A AD - Ospedale San Martino, Genoa, Italy. FAU - Barbui, T AU - Barbui T AD - Research Foundation, Ospedale Papa Giovanni XXIII, Bergamo, Italy. FAU - Rambaldi, A AU - Rambaldi A AD - Hematology and Bone Marrow Transplant Unit, Ospedale Papa Giovanni XXIII, Bergamo, Italy. FAU - Mesa, R AU - Mesa R AD - Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA. FAU - Tefferi, A AU - Tefferi A AD - Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Griesshammer, M AU - Griesshammer M AD - Academic Department of Hematology and Oncology, Johannes Wesling Teaching Hospital, Hans-Nolte-Strasse 1, Minden, Germany. FAU - Gupta, V AU - Gupta V AD - Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada. FAU - Harrison, C AU - Harrison C AD - Department of Haematology Guy's and St Thomas' NHS Foundation Trust, London, UK. FAU - Alchalby, H AU - Alchalby H AD - Department of Stem Cell Transplantation, University Hospital, Hamburg, Germany. FAU - Vannucchi, A M AU - Vannucchi AM AD - Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. FAU - Cervantes, F AU - Cervantes F AD - Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain. FAU - Robin, M AU - Robin M AD - Department of Hematology and Bone Marrow Transplantation, Saint Louis Hospital, Paris, France. FAU - Ditschkowski, M AU - Ditschkowski M AD - Department of Bone Marrow Transplantation, WTZ, Comprehensive Cancer Centre, University Hospital Essen, Essen, Germany. FAU - Fauble, V AU - Fauble V AD - Mayo Clinic Cancer Center, Scottsdale, AZ, USA. FAU - McLornan, D AU - McLornan D AD - Department of Haematology Guy's and St Thomas' NHS Foundation Trust, London, UK. AD - Department of Haematological Medicine, King's College Hospital, London, UK. FAU - Ballen, K AU - Ballen K AD - Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, USA. FAU - Popat, U R AU - Popat UR AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. FAU - Passamonti, F AU - Passamonti F AD - Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, Varese, Italy. FAU - Rondelli, D AU - Rondelli D AD - University of Illinois Hospital & Health Sciences System and University of Illinois Cancer Center, Chicago, IL, USA. FAU - Barosi, G AU - Barosi G AD - Center for the Study of Myelofibrosis, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. LA - eng PT - Journal Article PT - Review PT - Systematic Review DEP - 20150821 PL - England TA - Leukemia JT - Leukemia JID - 8704895 SB - IM MH - Donor Selection MH - *Hematopoietic Stem Cell Transplantation MH - Histocompatibility Testing MH - Humans MH - Primary Myelofibrosis/mortality/*therapy MH - Transplantation Conditioning MH - Transplantation, Homologous EDAT- 2015/08/22 06:00 MHDA- 2016/02/26 06:00 CRDT- 2015/08/22 06:00 PHST- 2015/06/25 00:00 [received] PHST- 2015/08/10 00:00 [accepted] PHST- 2015/08/22 06:00 [entrez] PHST- 2015/08/22 06:00 [pubmed] PHST- 2016/02/26 06:00 [medline] AID - leu2015233 [pii] AID - 10.1038/leu.2015.233 [doi] PST - ppublish SO - Leukemia. 2015 Nov;29(11):2126-33. doi: 10.1038/leu.2015.233. Epub 2015 Aug 21.