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Improving allogeneic stem cell transplantation in myelofibrosis

  • Progress in Hematology
  • Clinical aspects and treatment options in myeloproliferative neoplasms
  • Published:
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Abstract

In this review, we will outline dimensions in which outcome of patients with myelofibrosis undergoing curative treatment can be optimized: patient selection, transplant procedure, and posttransplant prevention or treatment of relapse. For patient selection, fortunately, as with several other hematologic malignancies, the management of patients with myelofibrosis has very much entered the molecular era, with the establishment of several driver and nondriver mutations, allowing more individualized selection for treatment. For the transplant procedure itself, different conditioning intensities do not seem to play a distinctive role with regards to outcome posttransplant but still need to be compared in the molecular era. While many patients nowadays may receive ruxolitinib before transplant, recent studies may facilitate fine-tuning and integration of ruxolitinib into the transplant algorithm. The role of novel inhibitors for the transplant setting remains unclear. For the posttransplant phase, evidence remains scarce, with experiences of donor-lymphocyte infusions for relapse management but more efforts are needed in understanding relapse and identifying and treating patients at high risk for relapse.

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  1. Nico Gagelmann and Nicolaus Kröger contributed equally.

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  1. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246, Hamburg, Germany

    Nico Gagelmann & Nicolaus Kröger

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  1. Nico Gagelmann
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Gagelmann, N., Kröger, N. Improving allogeneic stem cell transplantation in myelofibrosis. Int J Hematol 115, 619–625 (2022). https://doi.org/10.1007/s12185-022-03340-w

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