{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:54:22Z","timestamp":1787792062116,"version":"build-2784847793"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The role of spleen size and splenectomy for the prediction of post\u2010allogeneic hematopoietic stem cell transplant (allo\u2010HCT) outcome in myelofibrosis remains under debate. In EBMT registry, we identified a cohort of 1195 myelofibrosis patients transplanted between 2000\u20102017 after either fludarabine\u2010busulfan or fludarabine\u2010melphalan regimens. Overall, splenectomy was performed in 202 (16.9%) patients and its use decreased over time (28.3% in 2000\u20102009 vs 14.1% in 2010\u20102017 period). By multivariate analysis, splenectomy was associated with less NRM (HR 0.64, 95% CI 0.44\u20100.93, <jats:italic>P<\/jats:italic> =\u2009.018) but increased risk of relapse (HR 1.43, 95% CI 1.01\u20102.02, <jats:italic>P<\/jats:italic> =\u2009.042), with no significant impact on OS (HR 0.86, 95% CI 0.67\u20101.12, <jats:italic>P<\/jats:italic> =\u2009.274). However, in subset analysis comparing the impact of splenectomy vs specific spleen sizes, for patients with progressive disease, an improved survival was seen in splenectomised subjects compared to those patients with a palpable spleen length\u2009\u2265\u200915\u2009cm (HR 0.44, 95% CI 0.28\u20100.69, <jats:italic>P<\/jats:italic> &lt;\u2009.001), caused by a significant reduction in NRM (HR 0.26, 95% CI 0.14\u20100.49, <jats:italic>P<\/jats:italic> &lt;\u2009.001), without significantly increased relapse risk (HR 1.47, 95% CI 0.87\u20102.49, <jats:italic>P<\/jats:italic> =\u2009.147). Overall, despite the possible biases typical of retrospective cohorts, this study highlights the potential detrimental effect of massive splenomegaly in transplant outcome and supports the role of splenectomy for myelofibrosis patients with progressive disease and large splenomegaly.<\/jats:p>","DOI":"10.1002\/ajh.26020","type":"journal-article","created":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T16:41:50Z","timestamp":1602866510000},"page":"69-79","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Impact of spleen size and splenectomy on outcomes of allogeneic hematopoietic cell transplantation for myelofibrosis: A retrospective analysis by the chronic malignancies working party on behalf of European society for blood and marrow transplantation (EBMT)"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6297-9697","authenticated-orcid":false,"given":"Nicola","family":"Polverelli","sequence":"first","affiliation":[{"name":"Unit of Blood Diseases and Stem Cells Transplantation, Department of Clinical and Experimental Sciences University of Brescia  ASST Spedali Civili of Brescia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katya","family":"Mauff","sequence":"additional","affiliation":[{"name":"Leiden Data Office LUMC  Leiden Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaus","family":"Kr\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1388-9876","authenticated-orcid":false,"given":"Marie","family":"Robin","sequence":"additional","affiliation":[{"name":"Department of 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