title: Allogeneic haematopoietic stem cell transplantation for primary myelofibrosis and myelofibrosis evolved from other myeloproliferative neoplasms.
abstract: OBJECTIVE
  Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is the only curative treatment for myelofibrosis. Major improvements in the field, such as the introduction of reduced intensity conditioning regimens, have made transplant a better tolerated treatment that can be offered to older patients and those with comorbidities. However, treatment-related toxicities, graft-versus-host disease, infectious complications and relapse remain major problems posttransplant. We reviewed here the recent published data and outline the criteria to select patients with myelofibrosis who can benefit the most from this curative treatment.
  
  
  RESULTS
  Data regarding mutations in myelofibrosis have been useful to better define the prognosis of patients and have provided a tool to monitor minimal residual disease after transplantation. New data regarding the use of age and comorbidities has allowed a better selection of patients who can benefit from transplantation. Janus-activated kinase signal (JAK) 1/2 inhibitors pretransplant can improve patient's performance status and potentially improve transplant outcomes.
  
  
  CONCLUSIONS
  Improvements in the field of allo-HSCT, the ability to improve patient's performance status prior to transplant with JAK1/2 inhibitors and a more accurate disease risk stratification based on molecular mutations to select patients who can benefit from allo-HSCT should result in better transplant outcomes. Efforts should be made to transplant patients with myelofibrosis on prospective studies to answer some unresolved questions.
authors: aAdult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center bDepartment of Medicine, Weill Cornell Medical College, New York, New York, USA.
authors: Roni
authors: R
authors: Tamari
authors: Hugo
authors: H
authors: Castro-Malaspina
mesh_terms: D018450:Disease Progression; D020350:Graft vs Tumor Effect; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D009196:Myeloproliferative Disorders / Q000150:complications* / Q000473:pathology*; D055728:Primary Myelofibrosis / Q000209:etiology* / Q000628:therapy*; D012008:Recurrence; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome