TY - JOUR T1 - MIPSS70+ v2.0 predicts long-term survival in myelofibrosis after allogeneic HCT with the Flu/Mel conditioning regimen JF - Blood Advances JO - Blood Adv SP - 83 LP - 95 DO - 10.1182/bloodadvances.2018026658 VL - 3 IS - 1 AU - Ali, Haris AU - Aldoss, Ibrahim AU - Yang, Dongyun AU - Mokhtari, Sally AU - Khaled, Samer AU - Aribi, Ahmed AU - Afkhami, Michelle AU - Al Malki, Monzr M. AU - Cao, Thai AU - Mei, Matthew AU - O’Donnell, Margaret AU - Salhotra, Amandeep AU - Pullarkat, Vinod AU - Yang, Lixin AU - Stein, Anthony S. AU - Marcucci, Guido AU - Forman, Stephen J. AU - Nakamura, Ryotaro AU - Pillai, Raju AU - Snyder, David Y1 - 2019/01/08 UR - http://www.bloodadvances.org/content/3/1/83.abstract N2 - Favorable long-term OS and low relapse rates were achieved with allo-HCT and a Flu/Mel regimen in patients with MF.Both MIPSS70 and MIPSS70+ v2.0 scores can predict outcomes after allo-HCT.Although allogeneic hematopoietic cell transplantation (allo-HCT) is the only curative treatment for myelofibrosis (MF), data are limited on how molecular markers predict transplantation outcomes. We retrospectively evaluated transplantation outcomes of 110 consecutive MF patients who underwent allo-HCT with a fludarabine/melphalan (Flu/Mel) conditioning regimen at our center and assessed the impact of molecular markers on outcomes based on a 72-gene next-generation sequencing panel and Mutation-Enhanced International Prognostic Scoring System 70+ v2.0 (MIPSS70+ v2.0). With a median follow-up of 63.7 months, the 5-year overall survival (OS) rate was 65% and the nonrelapse mortality (NRM) rate was 17%. In mutational analysis, JAK2 V617F and ASXL1 mutations were the most common. By univariable analysis, higher Dynamic International Prognostic Scoring System scores, unrelated donor type, and very-high-risk cytogenetics were significantly associated with lower OS. Only CBL mutations were significantly associated with lower OS (hazard ratio [HR], 2.64; P = .032) and increased NRM (HR, 3.68; P = .004) after allo-HCT, but CALR, ASXL1, and IDH mutations did not have an impact on transplantation outcomes. Patient classification per MIPSS70 showed worse OS for high-risk (HR, 0.49; P = .039) compared with intermediate-risk patients. Classification per MIPSS70+ v2.0 demonstrated better OS when intermediate-risk patients were compared with high-risk patients (HR, 0.291) and much lower OS when very-high-risk patients were compared with high-risk patients (HR, 5.05; P ≤ .001). In summary, we present one of the largest single-center experiences of Flu/Mel-based allo-HCT, demonstrating that revised cytogenetic changes and MIPSS70+ v2.0 score predict transplantation outcomes, and thus can better inform physicians and patients in making decisions about allo-HCT. ER -