The Use of Allogeneic Hematopoietic Stem Cell Transplantation in Primary Myelofibrosis

Primary myelofibrosis (PMF) is a BCR-ABL1 negative myeloproliferative neoplasm characterized by clonal proliferation of myeloid cells. This leads to reactive bone marrow fibrosis, ultimately resulting in progressive marrow failure, hepatosplenomegaly, and extramedullary hematopoiesis. PMF is conside...

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Bibliographic Details
Published in:Journal of personalized medicine 2022-04, Vol.12 (4), p.571
Main Authors: Wolfe, Heather R, Horwitz, Mitchell E, Rein, Lindsay A M
Format: Article
Language:English
Subjects:
Age
Anemia
Asymptomatic
Bone marrow
Cell proliferation
Clinical trials
Fibrosis
Hematopoietic stem cells
Janus kinase
Janus kinase 2
Leukemia
Medical prognosis
Morbidity
Mortality
Mutation
Myelofibrosis
Myeloid cells
Palliative care
Patients
Precision medicine
Quality of life
Review
Risk groups
Stem cell transplantation
Thrombocytopenia
Tumors
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Description
Summary:Primary myelofibrosis (PMF) is a BCR-ABL1 negative myeloproliferative neoplasm characterized by clonal proliferation of myeloid cells. This leads to reactive bone marrow fibrosis, ultimately resulting in progressive marrow failure, hepatosplenomegaly, and extramedullary hematopoiesis. PMF is considered the most aggressive of the BCR-ABL1 negative myeloproliferative neoplasms with the least favorable prognosis. Constitutional symptoms are common, which can impact an individual's quality of life and leukemic transformation remains an important cause of death in PMF patients. The development of the Janus kinase 2 (JAK2) inhibitors have provided a good option for management of PMF-related symptoms. Unfortunately, these agents have not been shown to improve overall survival or significantly alter the course of disease. Allogenic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment option in PMF. However, allo-HSCT is associated with significant treatment-related morbidity and mortality and has historically been reserved for younger, high-risk patients. This review examines patient, disease, and transplant-specific factors which may impact transplant-related outcomes in PMF. Through the vast improvements in donor selection, conditioning regimens, and post-transplant care, allo-HSCT may provide a safe and effective curative option for a broader range of PMF patients in the future.
ISSN:2075-4426
2075-4426
DOI:10.3390/jpm12040571