Catholic University Catholic Hematology Hospital

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for myelofibrosis. However, it's not always a suitable option for everyone. It can be particularly challenging for older patients, those in poor overall health, or those with additional medical conditions. Furthermore, this type of transplant can lead to significant side effects and even mortality.

Therefore, it's crucial to evaluate each patient's risk level using tools such as the International Prognostic Scoring System (IPSS)Index (IPI). For patients in the low or intermediate-1 risk groups, conservative treatment options, which don't include HSCT, may be more beneficial and pose less risk. On the other hand, patients in the intermediate-2 or high-risk groups might be better candidates for HSCT. Even patients in the intermediate-1 risk group might consider HSCT if they require regular blood transfusions, if their immature blood cells exceed 2%, if they lack JAK2/Calreticulin/MPL gene mutations, or if they carry an ASXL1, EZH2, XRXF2, IDH1,IDH2 gene mutation according to next-generation DNA sequencing. These factors could indicate a poorer prognosis. For some patients, it may be reasonable to delay transplantation until there's evidence of poor prognostic factors or a lack of response to existing treatments.

For more information on myelofibrosis and hematopoietic stem cell transplantation, we encourage you to explore our resources.