Race/ethnicity and outcomes in hematopoietic stem cell transplantation (HCT) in myeloproliferative neoplasms (MPN): A single institutional study.

Authors

null

Snegha Ananth

University of Texas Health at San Antonio, San Antonio, TX

Snegha Ananth , Paul Shaughnessy , Behyar Zoghi , Jonathan Gelfond , Ruben A. Mesa

Organizations

University of Texas Health at San Antonio, San Antonio, TX, Texas Transplant Institute at Methodist Hospital, San Antonio, TX, Texas Transplant Institute Methodist Hospital, San Antonio, TX, UT Health San Antonio Cancer Center, San Antonio, TX, UT Health San Antonio, San Antonio, TX

Research Funding

No funding received

Background: Previous studies have demonstrated racial disparities in MPN outcomes, but there is no data regarding impact of race on outcomes of HCT in MPN. This is a retrospective study evaluating transplant related outcomes in Hispanics undergoing allogeneic HCT for MPN/MF in a large hospital in South Texas. Methods: A total of 45 patients who underwent HCT for MPN disorders from January 2008 to December 2020 at the Methodist Hospital, San Antonio were included. Race was self-reported by patients and obtained from electronic medical record along with other variables. Significance of variation in categorical outcomes were assessed with Chi-square tests. OS was estimated using the Kaplan-Meier method and compared between races using the log rank test. Results: This study analyzed 19 Non-Hispanic White (NHW) and 19 Hispanic (H) patients (7 patients were excluded due to unknown or other race). Patients primarily underwent transplantation for Myelofibrosis (n=19) followed by CMML (n=12) and MDS-MPN-U (n=7). There were no significant differences between NHW and H patients with regards to performance status, conditioning regimen, stem cell source and GvHD prophylaxis. However, H were younger at transplant with a median of 52 years (range 42-71) compared with 62 years (41-76) in NHW (p=0.50) and were more likely to have a haploidentical donor (47% vs 11%, p < 0.001). There were no significant differences in time to neutrophil (median 22 days (range 15-560) versus 25 days (range 8-48 days), p=0.7) or platelet recovery (median 24 days (range 15-636) versus 25 days (range 6-102), p=0.9) in NHW vs H patients. There were no significant differences in cumulative incidence of grade 1-2 and grade 3-4 acute GvHD between NHW (50 and 50%) vs H (40 and 60%) patients (p=0.4 and p=0.5, respectively). There was significant difference in the cumulative incidence of chronic GvHD (68% NHW compared to 37% H, p=0.03). Median OS was 6.75 years in NHW and 2.67 years in H (p=0.08). The cumulative incidence of Relapse Mortality (RM) and non-RM were not statistically significant between NHW and H, however H had higher percentage of relapse related mortality at 5 years (5.3% vs 17.5%)(Table). Among the 5 NHW and 8 H non-relapse deaths, causes of death were similar among the two groups – the most common being infection (20% and 38%, respectively), acute and chronic (40% and 25%) GvHD and graft failure (0% and 25%). Conclusions: NHW and H had comparable relapse, non-relapse and survival rates likely due to similar access to treatment and follow-up within a single institution. Larger and prospective studies are needed to further elucidate this important topic.

Outcome
NHW (%)
H (%)
p-value
non-RM

- 1 yr

- 2 yr

- 5 yr
0

10.5

44.2
0

15.8

55.5
0.8
RM

- 1 yr

- 2 yr

- 5 yr
5.3

5.3

5.3
5.3

10.5

17.5
0.2
Overall Survival

- 1 yr

- 2 yr

- 5 yr
94.7

84.2

57.7
94.7

73.7

27.1
0.08

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Hematologic Malignancies—Leukemia, Myelodysplastic Syndromes, and Allotransplant

Track

Hematologic Malignancies

Sub Track

Myeloproliferative Neoplasms (MPN) and Mast Cell Disorders

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e19083)

DOI

10.1200/JCO.2022.40.16_suppl.e19083

Abstract #

e19083

Abstract Disclosures