Fiche publication
Date publication
octobre 2025
Journal
Bone marrow transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RUBIO Marie Thérèse
Tous les auteurs :
Sobieralski P, Czerw T, Gras L, Koster L, Kröger N, Schroeder T, Friis L, Metafuni E, Passweg J, Robin M, Stelljes M, Broers AEC, Chevallier P, Zeiser R, Rubio MT, Verbeek M, Yonal-Hindilerden I, Pastore D, Zaucha J, Raj K, Drozd-Sokołowska J, Battipaglia G, Polverelli N, Hernández-Boluda JC, McLornan DP
Lien Pubmed
Résumé
Outcomes in myelofibrosis (MF) patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) appear unaffected by the intensity of the preparative regimen, defined traditionally as myeloablative (MAC) or reduced intensity conditioning (RIC). The Transplant Conditioning Intensity (TCI) index is an objective tool offering a precise measure of conditioning intensity. We explored the potential association between TCI score and overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) in 2454 MF patients undergoing allo-HCT between 2012 and 2021, selected from the EBMT registry. Patients receiving TCI-intermediate/high regimens had similar OS (HR 1.12, 95% CI 0.97-1.30) and PFS (HR 1.00, 95% CI 0.88-1.14) compared to TCI-low regimens. However, TCI-intermediate/high regimens were associated with lower risk of relapse (HR 0.74, 95% CI 0.61-0.91, p = 0.008) and higher risk of NRM (HR 1.24, 95% CI 1.04-1.48, p = 0.02). Our findings suggest that the TCI score provides a more clinically relevant stratification of conditioning intensity than the conventional MAC/RIC classification. While higher intensity TCI regimens are associated with lower RI, this benefit is offset by increased NRM, resulting in no survival advantage. However, the TCI index may enable a more personalized approach to conditioning regimen selection by balancing relapse risk with patient frailty.
Référence
Bone Marrow Transplant. 2025 10 15;:
