[Allogeneic hematopoietic stem cell transplantation for myeloproliferative neoplasms]

The median survival time in myelofibrosis is about 5 years, and allogeneic hematopoietic stem cell transplantation is the only curative treatment. Because the clinical course and prognosis of myelofibrosis is not uniform, transplantation-related death or long-term prognosis should be evaluated by varied prognostic prediction systems. This includes assessing gene mutation information in each patient, and the indication and timing of transplantation should be decided based on this information. Previous reports have shown that transplanted hematopoietic stem cells can be engrafted despite marked fibrosis in the bone marrow, and allogeneic hematopoietic stem cell transplantation is a curative treatment for myelofibrosis. However, the transplant-related mortality rate is 30-50%, and the overall survival rate is only around 50%. Future work should focus on methods to decrease transplant-related mortality, including the selection of stem cell source, the development of optimal pre-transplant treatment, and how to best incorporate JAK2 inhibitors before transplantation.