Dr. Jain on Treatment Options for Patients With Myelofibrosis Who Progress After Transplant

Tania Jain, MBBS, assistant professor of oncology, Division of Hematological Malignancies and Stem Cell Transplantation, Johns Hopkins University, discusses treatment options for patients with myelofibrosis who progress following allogeneic stem cell transplant (allo-SCT).

Selecting a treatment for patients who progress following allo-SCT largely depends on what kind of relapse occurs, explains Jain.

For example, patients who have a molecular relapse in which a JAK mutation or other molecular driver is positive should be considered for a donor lymphocyte infusion (DLI). Though, DLI is associated with an increased risk of graft-versus-host disease, says Jain.

Additionally, all patients who relapse after allo-SCT can receive JAK inhibition to reduce symptoms or splenomegaly.

Patients whose myelofibrosis transforms to acute myeloid leukemia (AML) should receive therapies that are indicated for patients with AML, says Jain.

In rare circumstances, younger patients may be considered for a second allo-SCT, concludes Jain.