{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:50:59Z","timestamp":1781769059562,"version":"3.54.5"},"reference-count":38,"publisher":"American Society of Hematology","issue":"21","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,11,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>There is a limited understanding of the clinical and molecular factors associated with outcomes of hematopoietic cell transplantation (HCT) in patients with BCR-ABL\u2013negative myeloproliferative neoplasms in blast phase (MPN-BP). Using the Center for International Blood and Marrow Transplant Research database, we evaluated HCT outcomes in 177 patients with MPN-BP. Ninety-five (54%) had sufficient DNA for targeted next-generation sequencing of 49 genes clinically relevant in hematologic malignancies. At 5 years, overall survival (OS), cumulative incidence of relapse, and nonrelapse mortality of the study cohort was 18%, 61%, and 25%, respectively. In a multivariable model, poor-risk cytogenetics was associated with inferior OS (hazard ratio [HR], 1.71; 95% CI, 1.21-2.41) due to increased relapse (HR, 1.93; 95% CI, 1.32-2.82). Transplants using mobilized peripheral blood (PB) were associated with better OS (HR, 0.60; 95% CI, 0.38-0.96). No difference in outcomes was observed in patients undergoing HCT with PB\/BM blasts &amp;lt;5% vs those with active leukemia. Among the 95 patients with molecular data, mutation of TP53, present in 23%, was the only genetic alteration associated with outcomes. In a multivariate model, TP53-mutant patients had inferior OS (HR, 1.99; 95% CI, 1.14-3.49) and increased incidence of relapse (HR, 2.59; 95% CI, 1.41-4.74). There were no differences in the spectrum of gene mutations, number of mutations, or variant allele frequency between patients undergoing HCT with PB\/BM blasts &amp;lt;5% vs those with active leukemia. Genetic factors, namely cytogenetic alterations and TP53 mutation status, rather than degree of cytoreduction predict outcomes of HCT in MPN-BP. No meaningful benefit of conventional HCT was observed in patients with MPN-BP and mutated TP53.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020002727","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T21:03:11Z","timestamp":1605042191000},"page":"5562-5573","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":45,"title":["Genetic factors rather than blast reduction determine outcomes of allogeneic HCT in <i>BCR-ABL<\/i>\u2013negative MPN in blast phase"],"prefix":"10.1182","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1419-8607","authenticated-orcid":false,"given":"Vikas","family":"Gupta","sequence":"first","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7440-3633","authenticated-orcid":false,"given":"Jose-Mario","family":"Capo-Chichi","sequence":"additional","affiliation":[{"name":"Genome Diagnostics, University Health Network, Toronto, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1404-0575","authenticated-orcid":false,"given":"Soyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI;"},{"name":"Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Huan","family":"Hu","sequence":"additional","affiliation":[{"name":"Center for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin P.","family":"Alyea","sequence":"additional","affiliation":[{"name":"Center of Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7592-2224","authenticated-orcid":false,"given":"Uday R.","family":"Popat","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald M.","family":"Sobecks","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-7839","authenticated-orcid":false,"given":"Bart L.","family":"Scott","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center\u2013University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3422-1309","authenticated-orcid":false,"given":"Aaron T.","family":"Gerds","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel B.","family":"Salit","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center\u2013University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4426-9023","authenticated-orcid":false,"given":"H. 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