Reduced-intensity haploidentical HCT (myelofibrosis)

Current understanding

Reduced-intensity conditioning haploidentical allogeneic HCT is being evaluated in a phase II trial for primary and secondary myelofibrosis, expanding donor availability for MF patients lacking matched donors. An initial cohort using pre-transplant JAK inhibition achieved universal engraftment with no graft failure but substantial GVHD, prompting an extension cohort that applies peri-transplant (pre-, during, and post-transplant) JAK inhibition to reduce GVHD without compromising engraftment (trial-early evidence).

Evidence log

• 2026-07-20 — Reduced Intensity Haploidentical Transplantation for the Treatment of Primary or Secondary Myelofibrosis: cross-connection with pretransplant-ruxolitinib: Pre-transplant ruxolitinib bridging is the initial JAKi schedule evaluated within this haploidentical RIC HCT phase II trial, where it produced universal engraftment but high GVHD. (novelty: 3)

Open questions

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