Peri-transplant momelotinib in myelofibrosis

Current understanding

Momelotinib (JAK1/JAK2/ACVR1 inhibitor) is being evaluated in a phase I study for safety and tolerability when administered during and after allogeneic HCT in myelofibrosis patients. Its dual JAK/ACVR1 mechanism — with established anemia benefit via hepcidin suppression — positions it as a potentially attractive peri-transplant agent that could simultaneously address splenomegaly, GVHD risk, and post-transplant cytopenias/erythroid recovery. Early-phase data are pending; comparative positioning versus ruxolitinib and gecacitinib in this window remains undefined.

Evidence log

• 2026-03-31 — Momelotinib During and After HCT in Myelofibrosis: cross-connection with post-transplant-erythroid-engraftment-mf: Momelotinib’s ACVR1/hepcidin-axis activity makes peri-transplant dosing mechanistically relevant to post-transplant erythroid recovery, potentially overlapping with luspatercept’s role for poor erythroid engraftment. (novelty: 3)

Open questions

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