Retrospective case series finds manageable toxicity and reliable engraftment in high-risk myeloid malignancies, indicating selinexor is feasible for pre-transplant conditioning.
Key Points
To evaluate the feasibility and safety of incorporating selinexor into conditioning regimens before allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with high-risk myeloid malignancies.
Retrospective single-center case series of 12 consecutive patients receiving selinexor-containing conditioning regimens prior to allo-HSCT.
Evaluated toxicities, engraftment, graft-versus-host disease (GVHD), relapse, non-relapse mortality (NRM), progression-free survival (PFS), and overall survival (OS) over a median follow-up of 42 months (95% CI, 25–42 months).
All 12 patients completed planned selinexor therapy with manageable toxicity, achieving neutrophil engraftment in 100% of evaluable patients and platelet engraftment in the majority, with no unexpected organ toxicities.
Median PFS was 9.0 months (95% CI, 2.0–25 months) and median OS was 10.0 months (95% CI, 2–30 months).
At 12 months, cumulative incidence was 33.3% (95% CI, 10.3%–58.8%) for relapse and 33.3% (95% CI, 10.3%–58.8%) for NRM, while day +100 acute GVHD was 41.7% (95% CI, 15.2%–66.5%) and 12-month chronic GVHD was 25.0% (95% CI, 6.0%–50.5%).