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Allo-SCT for myelofibrosis: reversing the chronic phase in the JAK inhibitor era?

Bone Marrow Transplantation volume 50, pages 628–636 (2015)Cite this article

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Abstract

At present, allo-SCT is the only curative treatment for patients with myelofibrosis (MF). Unfortunately, a significant proportion of candidate patients are considered transplant ineligible due to their poor general condition and advanced age at the time of diagnosis. The approval of the first JAK inhibitor, ruxolitinib, for patients with advanced MF in 2011 has had a qualified impact on the treatment algorithm. The drug affords substantial improvement in MF-associated symptoms and splenomegaly but no major effect on the natural history. There has, therefore, been considerable support for assessing the drug’s candidacy in the peritransplant period. The drug’s precise impact on clinical outcome following allo-SCT is currently not known; nor are the drug’s long-term efficacy and safety known. Considering the rarity of MF and the small proportion of patients who undergo allo-SCT, well designed collaborative efforts are required. In order to address some of the principal challenges, an expert panel of laboratory and clinical experts in this field was established, and an independent workshop held during the 54th American Society of Hematology Annual Meeting in New Orleans, USA on 6 December 2013, and the European Hematology Association's Annual Meeting in Milan, Italy on 13 June 2014. This document summarizes the results of these efforts.

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Acknowledgements

We thank Alpine Oncology Foundation, in particular Dr Alpa Parmar, who helped organize the workshop and Incyte Corporation (USA) for their unrestricted educational support.

Author Contributions

RT, TIM and RH designed the outline strategy of the manuscript and analyzed and interpreted the data. RT and TIM wrote the first draft of the manuscript. All authors participated in writing significant sections of the paper and approved the final version of the manuscript.

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Author notes

  1. R Tamari and T I Mughal: RT and TIM are co-first authors.

Authors and Affiliations

  1. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    R Tamari & S Giralt

  2. Division of Hematology and Oncology, Tufts Medical Center, Boston, MA, USA

    T I Mughal

  3. University of Illinois, Chicago, IL, USA

    D Rondelli

  4. Dana Farber Cancer Institute, Boston, MA, USA

    R Hasserjian

  5. Princess Margaret Cancer Center, Toronto, Canada

    V Gupta

  6. University of Chicago, Chicago, IL, USA

    O Odenike

  7. Mayo Clinic Cancer Center, Scottsdale, AZ, USA

    V Fauble

  8. Papa Giovani XXIII Hospital and Research Center, Bergamo, Italy

    G Finazzi

  9. Federico II University, Naples, Italy

    F Pane

  10. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    J Mascarenhas & R Hoffman

  11. Huntsman Cancer Center, Salt Lake City, UT, USA

    J Prchal

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  1. R Tamari
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Corresponding author

Correspondence to T I Mughal.

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Competing interests

VG was a member of the Scientific Advisory Board at Novartis and Incyte, and received research support from Novartis and Incyte. RHa was a member of the Scientific Advisory Board at Incyte. JM received research support from Novartis and Incyte. TIM was a consultant at Novartis and Incyte. OO was a member of the Scientific Advisory Board at Sanofi-Aventis, Incyte, Spectrum Pharmaceuticals, Sunesis Pharmaceuticals and Algeta Pharmaceuticals, and received research support from Eisai Pharmaceuticals and TopoTarget Pharmaceuticals. All other authors declare no conflict of interest.

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Tamari, R., Mughal, T., Rondelli, D. et al. Allo-SCT for myelofibrosis: reversing the chronic phase in the JAK inhibitor era?. Bone Marrow Transplant 50, 628–636 (2015). https://doi.org/10.1038/bmt.2014.323

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