Recommendations on selection and preparation measures for patients with MF referred to HSCT, as developed by the European Leukemia Net/International Working Group–Myeloproliferative Neoplasms Research and Treatment panel
| Recommended . | Indicated* . | Not recommended . |
|---|---|---|
| Patient selection | ||
| Patients with intermediate-2-risk or high-risk disease according to IPSS, DIPSS, or DIPSS-plus, and age <70 y | Patients with intermediate-1-risk disease and age <65 y if they present with either refractory, transfusion-dependent anemia or more than 2% blasts in peripheral blood or adverse cytogenetics | Patients with low-risk disease |
| Patients with intermediate-1-risk disease if they are triple negative, ASXL1 positive, or both | Patients in blast transformation | |
| Patients in blast transformation after achieving a partial or complete remission of leukemia with debulking therapy | ||
| Pretransplant management | ||
| Iron chelation therapy in severely iron overloaded patients only | Ruxolitinib treatment of patients with a symptomatic spleen and/or constitutional symptoms | Splenic irradiation–splenectomy (case-by-case decision) |
| Recommended . | Indicated* . | Not recommended . |
|---|---|---|
| Patient selection | ||
| Patients with intermediate-2-risk or high-risk disease according to IPSS, DIPSS, or DIPSS-plus, and age <70 y | Patients with intermediate-1-risk disease and age <65 y if they present with either refractory, transfusion-dependent anemia or more than 2% blasts in peripheral blood or adverse cytogenetics | Patients with low-risk disease |
| Patients with intermediate-1-risk disease if they are triple negative, ASXL1 positive, or both | Patients in blast transformation | |
| Patients in blast transformation after achieving a partial or complete remission of leukemia with debulking therapy | ||
| Pretransplant management | ||
| Iron chelation therapy in severely iron overloaded patients only | Ruxolitinib treatment of patients with a symptomatic spleen and/or constitutional symptoms | Splenic irradiation–splenectomy (case-by-case decision) |
Not a strong recommendation, but case-by-case approach.