Role of hematopoietic stem cell transplantation in patients with myeloproliferative disease

Hematol Oncol Clin North Am. 2014 Dec;28(6):1023-35. doi: 10.1016/j.hoc.2014.08.003. Epub 2014 Oct 3.

Abstract

Myeloproliferative neoplasms (MPN) are clonal hematopoietic stem cell disorders. While some MPN patients have an indolent course, all are at risk of progressing to severe marrow failure or transforming into acute leukemia. Allogeneic hematopoietic cell transplantation (allo-HCT) is the only potential curative therapy. Major pre-transplant risk factors are disease stage of the MPN, the presence of comorbid conditions and the use of HLA non-identical donors. The development of reduced-intensity conditioning regimens has allowed for successful allo-HCT even for older patients and patients with comorbid conditions. The pre-transplant use of JAK2 inhibitors, which may be effective in down staging a patient's disease, may improve the outcomes following allo-HCT.

Keywords: Essential thrombocythemia; Hematopoietic stem cell transplantation; Myelofibrosis; Myeloproliferative neoplasms (MPN); Polycythemia vera; Ruxolitinib.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Combined Modality Therapy
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Janus Kinase 2 / antagonists & inhibitors
  • Myeloproliferative Disorders / enzymology
  • Myeloproliferative Disorders / therapy*
  • Nitriles
  • Pyrazoles / therapeutic use*
  • Pyrimidines
  • Transplantation Conditioning / methods*
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib
  • Janus Kinase 2