How I treat Ph⁻MPN-BP. My approach to the treatment of MPN-BP is summarized. The accompanying text in Box 1 outlines in greater detail the treatment algorithm illustrated here. *The promise of IDH1/2 inhibitor–based therapy is not yet validated in MPN-BP and is recommended in the context of clinical trial participation. †HMA-based therapy has not been validated as superior to intensive chemotherapy (ICT) in TP53-mutated cases, and the choice of 1 over the other must be based on the individual case.