Dr. Snyder on the Utility of Transplant in MPNs

David S. Snyder, MD, associate chair, Department of Hematology and Hematopoietic Cell Transplantation, professor, Hematology and Hematopoietic Cell Transplantation, and hematologist/oncologist, City of Hope, discusses the utility of transplant in myeloproliferative neoplasms (MPNs).

Historically, patients up to the age of 50 to 55 were considered for transplant. However, the use of reduced-intensity conditioning regimens has enabled patients up to 75 years of age, as well as those with comorbidities to undergo transplant, says Snyder.

The availability of donors has also expanded, says Snyder. Patients eligible for transplant who do not have a fully matched sibling may be paired with a fully matched unrelated donor, or a partially mismatched unrelated donor. Alternative options include cord blood and haploidentical donors.

Patients who are candidates for transplant should be started on a JAK2 inhibitor, says Snyder. During treatment, it is important to determine the optimal time to move forward with transplant.

New prognostic scoring systems have the potential to simplify the decision of when to undergo transplant, concludes Snyder.