scholarly journals Allogeneic hematopoietic cell transplantation in patients with AML not achieving remission: potentially curative therapy

2017 ◽  
Vol 52 (8) ◽  
pp. 1083-1090 ◽  
Author(s):  
B Gyurkocza ◽  
H M Lazarus ◽  
S Giralt
Blood ◽  
2012 ◽  
Vol 120 (7) ◽  
pp. 1367-1379 ◽  
Author(s):  
Vikas Gupta ◽  
Parameswaran Hari ◽  
Ronald Hoffman

Abstract The discovery of JAK2617F mutation paved the way for the development of small molecule inhibitors of JAK1/2 resulting in first approved JAK1/2 inhibitor, ruxolitinib, for the treatment of patients with myelofibrosis (MF). Although JAK1/2 inhibitor therapy is effective in decreasing the burden of symptoms associated with splenomegaly and MF-related constitutional symptoms, it is neither curative nor effective in reducing the risk of leukemic transformation. Presently, allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for MF. A significant risk of regimen-related toxicities, graft failure, and GVHD are major barriers to the success of HCT in MF. Because of significant HCT-associated morbidity and mortality, divergent opinions regarding its appropriate role in this clinical situation have emerged. In this review, the risk-benefit ratios of modern drug therapy compared with HCT in MF patients are analyzed. A risk-adapted approach individualized to each patient's biologic characteristics and comorbidities is described, which is currently warranted in determining optimal treatment strategies for patients with MF. Inclusion of JAK1/2 inhibitor therapy in future transplant conditioning regimens may provide an opportunity to overcome some of these barriers, resulting in greater success with HCT for MF patients.


2020 ◽  
Vol 40 (11) ◽  
pp. 6531-6537
Author(s):  
KRZYSZTOF CZYŻEWSKI ◽  
ROBERT DĘBSKI ◽  
NATALIA BARTOSZEWICZ ◽  
EWA DEMIDOWICZ ◽  
MONIKA RICHERT-PRZYGOŃSKA ◽  
...  

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