Mentioned 12× · first seen 28-apr-2026 · last seen 13-sep-2026

Peri-transplant ruxolitinib for GVHD prevention

Current understanding

Continuation of ruxolitinib through the peri-transplant period (extending beyond pre-transplant bridging into conditioning and early post-transplant) is being evaluated as a strategy to reduce GVHD incidence in myelofibrosis patients undergoing allo-HSCT. Early trial data suggest low rates of acute and chronic GVHD with this approach, though optimal taper schedules and integration with standard GVHD prophylaxis remain to be defined.

Evidence log

2026-07-20 — Reduced Intensity Haploidentical Transplantation for the Treatment of Primary or Secondary Myelofibrosis: In RIC haploidentical HCT for MF, an initial cohort with pre-transplant-only JAK inhibition showed universal engraftment but substantial GVHD, prompting a new cohort applying JAK inhibitor before, during, and after transplant — extending the peri-transplant JAK-inhibition-for-GVHD rationale specifically to the haplo-donor context. (novelty: 3)
2026-07-01 — CASPALLO: Allodepleted T Cells Transduced With Inducible Caspase 9 Suicide Gene: CASPALLO introduces a fundamentally different GvHD-control mechanism from peri-transplant JAK inhibition — a conditional cell-elimination safety switch (iCasp9/AP1903) on engineered donor T cells — expanding the GvHD-mitigation toolkit beyond pharmacologic immunosuppression to genetic circuit-based control. (novelty: 4)
2026-06-03 — Hyperbaric Oxygen Therapy and Allogeneic Peripheral Blood Stem Cell (PBSC) Transplant: An early-phase trial of peri-transplant hyperbaric oxygen therapy (HBOT) in myeloid malignancies (including MF, CMML, MDS/MPN overlap) targets GVHD among its endpoints, introducing a non-pharmacologic, non-JAK-pathway adjunct alongside the JAK-inhibitor-dominated GVHD prophylaxis landscape. (novelty: 4)
Foundation — FDA Awards $18 Million in Grants for Advancing Treatment of Rare Diseases: FDA awarded $2M to OncImmune for CD24Fc as a non-JAK-pathway GVHD prevention strategy in MPN allo-HSCT, introducing an innate-immunity-targeted alternative to the JAK-inhibitor-based prophylaxis paradigm dominating this space. (novelty: 3)
2026-04-08 — Reduced Intensity Allogeneic HCT in Advanced Hematologic Malignancies w/T-Cell Depleted Graft: Parallel GVHD-minimization strategy: rather than pharmacologic JAK inhibition, an early trial uses RIC plus T-cell depleted, immunoregulatory-enriched donor grafts (matched or haploidentical) to limit GVHD in older/unfit patients — graft engineering as an alternative or complementary lever to peri-transplant JAK inhibitors. (novelty: 3)
2026-02-19 — Ruxolitinib Before, During and After Hematopoietic Cell Transplant in Older Patients With Myelofibrosis and Myelodysplastic Syndrome/Myeloproliferative Neoplasm Overlap Syndromes: A phase II trial of peri-transplant ruxolitinib (before, during, after HCT) added to tacrolimus/methotrexate prophylaxis extends the strategy to older patients with myelofibrosis and MDS/MPN overlap syndromes, broadening the eligible population beyond classical MF. (novelty: 3)
2026-03-31 — Momelotinib During and After HCT in Myelofibrosis: A phase I trial of momelotinib administered during and after HCT in myelofibrosis adds a JAK1/2/ACVR1 inhibitor to the growing list of peri-transplant JAK-pathway agents (alongside ruxolitinib, itacitinib, gecacitinib) being evaluated for tolerability and potential GVHD-modulating effects. (novelty: 3, trial-early) (novelty: 3)
2026-04-14 — Peritransplant Ruxolitinib for Patients With Primary and Secondary Myelofibrosis: A phase II trial is evaluating peritransplant ruxolitinib (pre-, during, and post-HSCT) in primary and secondary myelofibrosis with endpoints of GVHD incidence/severity, survival, and quality of life — formalizing the structured protocol behind earlier OncLive-reported low-GVHD signals. (novelty: 3)
2026-03-30 — Itacitinib, Tacrolimus, and Sirolimus for the Prevention of GVHD in Patients With Acute Leukemia, Myelodysplastic Syndrome, or Myelofibrosis Undergoing Reduced Intensity Conditioning Donor Stem Cell Transplantation: A phase IIa trial of itacitinib (JAK1-selective) added to tacrolimus/sirolimus for GVHD prophylaxis in RIC allo-HSCT (including myelofibrosis) extends the JAK-inhibition-for-GVHD-prevention paradigm beyond ruxolitinib to a more selective JAK1 agent. (novelty: 3)
2026-02-27 — Efficacy and Safety of Gecacitinib Hydrochloride in Prophylaxis Acute Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Myelofibrosis: An early-phase trial of gecacitinib hydrochloride (a novel JAK/ACVR1 dual inhibitor) + ATG for aGVHD prophylaxis in MF allo-HSCT introduces an alternative JAK-pathway agent to ruxolitinib in the peri-transplant GVHD prevention space, with the added ACVR1 inhibition mechanism. (novelty: 4)
April 2, 2 — Peri-Transplant Ruxolitinib Leads to Low GVHD Incidence in Myelofibrosis - OncLive: cross-connection with pretransplant-ruxolitinib: Pre-transplant bridging with ruxolitinib may be continued into the peri-transplant window, where it appears to additionally reduce GVHD risk — linking bridging strategy to GVHD prophylaxis. (novelty: 3)