RELEVANCE OF MARROW FIBROSIS IN BONE-MARROW TRANSPLANTATION - A RETROSPECTIVE ANALYSIS OF ENGRAFTMENT

A retrospective study compared posttransplant engraftment parameters i n 203 patients with myelofibrosis (MF) with those in a population of 2 03 matched controls without MF. There were no significant differences between these groups in the proportions of patients who died without a chieving engraftment and in the disease-free survival distributions. F urthermore. comparisons between the two groups of patients reaching th e respective endpoints showed no differences in the time distributions for reaching 0.5 or 1.0 x 10(9)/L granulocytes, but the time to plate let transfusion independence was 3 days longer in patients with MF. In further analysis, results for 33 patients with severe MF were compare d with those of their respective controls. The proportions of patients with severe MF who died without reaching these engraftment endpoints and the disease-free survival distributions in the two groups were sim ilar. Among patients who reached the respective engraftment endpoints, there was no statistically significant difference in the pace of gran ulocyte recovery. In patients with severe MF, there was a 7-day delay in the time to reach platelet transfusion independence and a 2-day del ay in the time to reach red blood cell independence, but the differenc es were not statistically significant. The present results do not subs tantiate concerns raised by earlier studies. MF may delay the time to reach platelet independence by approximately 3 days and may increase p latelet transfusion requirements, but no other perturbation of hematop oietic reconstitution was apparent. (C) 1995 by The American Society o f Hematology.