Optimizing reduced-intensity conditioning regimens for myeloproliferative neoplasms

Abstract

The myeloproliferative neoplasms (MPNs) are a group of clonal disorders that arise from a pluripotent hematopoietic stem cell and are characterized by excess cellular proliferation. These disorders tend to be chronic in nature and can terminate over time into a bone marrow failure syndrome characterized by marrow fibrosis or transform into a leukemic phase. MPNs are predominantly diseases of the elderly and this is one reason why until very recently the standard treatment was supportive care. The only curative modality for these disorders is allogeneic hematopoietic cell transplantation. The introduction of reduced-intensity conditioning regimens now allows this life-saving therapy to be offered to elderly patients who were previously considered ineligible for high-dose conditioning owing to age or comorbidity. In this review, we will summarize the current strategies and future directions regarding the use of reduced-intensity conditioning regimens in the treatment of MPNs.

Keywords::

• bcr–abl
• graft-versus-leukemia
• JAK-2
• myeloproliferative neoplasm
• reduced-intensity conditioning
• stem cell transplant

Acknowledgements

The authors would like to thank Bonnie Larson, Helen Crawford and Sue Carbonneau for assistance with the preparation and editing of the manuscript.

Financial & competing interests disclosure

This work was supported in part by PHS grants DK082783, HL36444, and CA18029 from the NIH. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.