Allogeneic stem cell transplant

Current understanding

Only curative therapy for MPN, reserved for high-risk myelofibrosis. Decision pivots on transplant scoring (MIPSS70, MTSS), age, and donor availability.

Evidence log

• 2026-07-20 — Reduced Intensity Haploidentical Transplantation for the Treatment of Primary or Secondary Myelofibrosis: cross-connection with reduced-intensity-haplo-hct-mf: Haploidentical RIC HCT extends allogeneic transplant access to MF patients lacking matched donors, with peri-transplant JAK inhibition as the GVHD-mitigation strategy. (novelty: 3)
• 2026-07-16 — Study of Tagraxofusp for Post-Transplant Maintenance for Patients With CD 123+ AML, MDS, MF and CMML (HSCT 002): cross-connection with tagraxofusp-cd123-post-hct-maintenance: Tagraxofusp is being tested as a post-allo-HCT maintenance strategy to reduce relapse in CD123+ myeloid malignancies including MF and CMML. (novelty: 3)
• 2026-06-16 — Final analysis of phase 2 clinical trial of ruxolitinib and azacitidine combination therapy in patients with myelodysplastic syndrome/myeloproliferative neoplasms.: cross-connection with azacitidine-ruxolitinib-combination: Final Phase 2 data suggest particularly encouraging OS in MDS/MPN patients bridged from aza+rux combination to subsequent allogeneic transplant, linking the combination to a transplant-bridging role in overlap syndromes. (novelty: 3)
• 2026-06-30 — A systematic review of 47 published cases of extramedullary hematopoiesis in myelofibrosis: clinical patterns, treatment responses, and prognostic implications.: cross-connection with ruxolitinib: Systematic review of atypical EMH in MF recommends early transplant referral for patients presenting with EMH, positioning ruxolitinib-based control as a bridge to allo-HSCT. (novelty: 3)
• 2026-07-01 — CASPALLO: Allodepleted T Cells Transduced With Inducible Caspase 9 Suicide Gene: cross-connection with icasp9-allodepleted-tcells-gvhd: iCasp9-transduced allodepleted T cells are an adjunct to allo-HSCT aimed at accelerating immune reconstitution with a controllable GvHD safety switch. (novelty: 4)
• 2026-06-23 — A Pragmatic Clinical Trial to Prevent Relapse for Myeloid Malignancies With Measurable Disease Prior to Allogeneic Transplant: cross-connection with post-transplant-maintenance-hma: MRD-guided post-transplant maintenance trial directly links allo-HCT outcomes to HMA-based maintenance strategies for myeloid malignancies including MPNs. (novelty: 3)
• 2026-06-17 — Preemptive CIML NK Cell Therapy After Hematopoietic Stem Cell Transplantation: cross-connection with post-transplant-relapse-ciml-nk: CIML NK + IL-2 is being evaluated as a preemptive post-allo-HSCT intervention to reduce relapse risk after transplant in MDS/MPN overlap. (novelty: 4)
• 2026-06-03 — Hyperbaric Oxygen Therapy and Allogeneic Peripheral Blood Stem Cell (PBSC) Transplant: cross-connection with hyperbaric-oxygen-therapy-allo-hsct: HBOT is being tested as a peri-transplant adjunct to allo-HSCT to improve engraftment kinetics and reduce transplant-related toxicities (GVHD, mucositis). (novelty: 4)
• Foundation — FDA Awards $18 Million in Grants for Advancing Treatment of Rare Diseases: cross-connection with cd24fc-gvhd-prevention-mpn: CD24Fc is being developed specifically as a GVHD-prevention adjunct for MPN patients undergoing allogeneic stem cell transplant. (novelty: 3)
• 2026-05-15 — Prospective Single-Arm Clinical Study of Thiotepa-Containing Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Chronic Myelomonocytic Leukemia: cross-connection with thiotepa-busulfan-fludarabine-conditioning-cmml: Defines a CMML-specific conditioning option within the broader allo-HSCT framework for MPN/MDS-MPN overlap diseases. (novelty: 3)
• 2026-04-03 — Fludarabine and Busulfan vs. Fludarabine, Busulfan and Total Body Irradiation: cross-connection with fludarabine-busulfan-tbi-conditioning: FluBu+low-dose TBI is being tested as an intensified conditioning option for allogeneic SCT in myeloid malignancies. (novelty: 3)
• 2026-03-30 — Inqovi Maintenance Therapy in Myeloid Neoplasms: Trial-early evidence: oral decitabine/cedazuridine (ASTX727/Inqovi) being prospectively evaluated as post-transplant maintenance to reduce relapse in MDS/CMML, adding to the growing list of HMA-based maintenance strategies after allo-SCT. (novelty: 3)
• 2026-04-03 — A Phase 1 Trial of CIML NK Cell Infusion for Myeloid Disease Relapse After Hematopoietic Cell Transplantation: cross-connection with ciml-nk-cell-infusion-il2: CIML NK + IL-2 is positioned as a salvage immunotherapy for myeloid disease (including MPN) relapse following allogeneic stem cell transplant. (novelty: 4)
• 2026-03-05 — Olutasidenib for the Treatment of Patients With IDH1 Mutated AML, MDS or CMML After Donor Hematopoietic Cell Transplant: cross-connection with olutasidenib-idh1-inhibitor-post-transplant: Olutasidenib is being studied as maintenance therapy following allogeneic stem cell transplant in IDH1-mutated myeloid malignancies, including CMML. (novelty: 3)
• 2026-03-31 — Momelotinib During and After HCT in Myelofibrosis: cross-connection with momelotinib: First prospective trial of momelotinib administered during and after allogeneic HCT in myelofibrosis. (novelty: 3)
• 2026-04-20 — Luspatercept in Preventing Poor Erythroid Engraftment for Hematological Malignancies With Moderate to Severe Myelofibrosis: cross-connection with luspatercept-mpn-posttransplant: Luspatercept is being prospectively evaluated as a peri-/post-transplant supportive agent to prevent poor erythroid engraftment specifically in myelofibrosis patients undergoing allo-HSCT. (novelty: 4)
• 2026-03-13 — Gecacitinib Pre-, During- and Post-HSCT for Patients With Primary or Secondary Myelofibrosis: cross-connection with gecacitinib-jak-acvr1-inhibitor: Trial integrates gecacitinib into pre-, during-, and post-HSCT phases, positioning it as a candidate transplant-bridging agent in MF. (novelty: 3)
• 2026-04-14 — Peritransplant Ruxolitinib for Patients With Primary and Secondary Myelofibrosis: cross-connection with peritransplant-ruxolitinib-gvhd: Peri-transplant ruxolitinib protocol is delivered around allogeneic HSCT in MF, integrating JAK inhibition into the transplant continuum for GVHD prophylaxis. (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: cross-connection with itacitinib-tacrolimus-sirolimus-gvhd: Itacitinib combination is being investigated as GVHD prophylaxis specifically in the RIC allo-SCT setting, directly linking this prophylaxis regimen to the transplant modality page. (novelty: 3)
• 2026-03-11 — High Dose Ruxolitinib and Allogeneic Stem Cell Transplantation in Myelofibrosis Patients With Splenomegaly: cross-connection with pretransplant-ruxolitinib: High-dose ruxolitinib + busulfan as a conditioning regimen directly links pre-transplant ruxolitinib strategy to allogeneic SCT protocol design, addressing splenomegaly as a known barrier to engraftment. (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: cross-connection with gecacitinib-jak-acvr1-inhibitor: Gecacitinib + ATG is being evaluated as aGVHD prophylaxis in MF patients undergoing allo-HSCT, linking this novel JAK/ACVR1 inhibitor directly to transplant outcomes. (novelty: 4)
• 2026-03-16 — Decitabine With Ruxolitinib, Fedratinib or Pacritinib for the Treatment of Accelerated/Blast Phase Myeloproliferative Neoplasms: cross-connection with astx727-cedazuridine-decitabine: Decitabine + JAK inhibitor evaluated specifically as a pre-transplant bridging strategy to allogeneic SCT in AP/BP-MPN. (novelty: 3)
• April 2, 2 — Peri-Transplant Ruxolitinib Leads to Low GVHD Incidence in Myelofibrosis - OncLive: Trial-early (OncLive): Peri-transplant ruxolitinib administration linked to reduced GVHD incidence in myelofibrosis allo-SCT recipients, reinforcing peri-transplant JAK inhibition as a GVHD-mitigation strategy. (novelty: 3)

Open questions

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