Hematology Department, Hospital Clínico Universitario-INCLIVA, Valencia, Spain.
Hematology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland.
Best Pract Res Clin Haematol. 2022 Jun;35(2):101369. doi: 10.1016/j.beha.2022.101369. Epub 2022 Aug 3.
Myelofibrosis (MF) is a chronic myeloproliferative neoplasm with a very heterogenous clinical course. Median survival of patients with overt MF is close to 6 years, but with great individual variability. Allogeneic hematopoietic cell transplantation (allo-HCT) constitutes the only curative treatment, yet the advanced age of MF patients, together with significant transplant-related mortality, limit the applicability of this procedure in clinical practice to less than 10% of patients. In this article, we review the current indications for allo-HCT in MF and factors that should be considered when selecting candidates for the procedure. To this end, we describe the prognostic tools that have been developed to predict survival in MF patients managed with conventional pharmacological therapies and allo-HCT. We then summarize the main results of allo-HCT, review practical aspects of the procedure, and discuss optimal timing, particularly in relation to JAK inhibitor treatment.
骨髓纤维化（MF）是一种慢性骨髓增生性肿瘤，具有非常异质性的临床病程。显性 MF 患者的中位生存期接近 6 年，但个体差异很大。异基因造血细胞移植（allo-HCT）是唯一的治愈性治疗方法，但 MF 患者的年龄较大，以及显著的移植相关死亡率，限制了该程序在临床实践中的适用性，不到 10%的患者适用。在本文中，我们回顾了 MF 患者 allo-HCT 的当前适应证，以及在选择该程序候选者时应考虑的因素。为此，我们描述了已开发用于预测接受常规药物治疗和 allo-HCT 治疗的 MF 患者生存的预后工具。然后，我们总结了 allo-HCT 的主要结果，回顾了该程序的实际方面，并讨论了最佳时机，特别是与 JAK 抑制剂治疗的关系。
