{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:53:28Z","timestamp":1791604408093,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82500213"],"award-info":[{"award-number":["82500213"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Significant splenomegaly remains a major barrier to successful allogeneic hematopoietic cell transplantation (allo\u2010HCT) in myelofibrosis (MF), contributing to delayed engraftment and an increased risk of graft failure. Systemic JAK inhibition and splenic irradiation are commonly used as independent pretransplant strategies; however, evidence regarding their sequential use and integration into contemporary conditioning platforms remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center retrospective study of nine patients with MF who underwent allo\u2010HCT between 2020 and 2025. Patients received sequential high\u2010dose ruxolitinib followed by low\u2010dose splenic irradiation (LDSI) as pretransplant spleen\u2010directed therapy prior to a fludarabine\/busulfan\u2010based conditioning regimen. Spleen response, engraftment kinetics, and transplant outcomes were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>High\u2010dose ruxolitinib reduced median spleen length from 185 to 172 mm, followed by a further decrease to 137 mm after LDSI. All patients achieved engraftment, with median times to neutrophil and platelet recovery of 15 and 19 days, respectively. The cumulative incidence of any\u2010grade acute graft\u2010versus\u2010host disease (GVHD) was 22.2%, and moderate chronic GVHD occurred in 11.1%. The estimated 2\u2010year overall survival was 88.9%, and the estimated 2\u2010year GVHD\u2010free and relapse\u2010free survival (GRFS) was 76.2%. The estimated 2\u2010year cumulative incidence of relapse was 12.7%, and estimated non\u2010relapse mortality was 11.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sequential high\u2010dose ruxolitinib followed by LDSI appeared feasible and was associated with stepwise pretransplant spleen reduction and encouraging early transplant outcomes following allogeneic HCT with fludarabine\/busulfan\u2010based conditioning. Given the small sample size and absence of a comparator group, this combined systemic and local spleen\u2010directed strategy warrants further evaluation in prospective multicenter studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The authors have confirmed clinical trial registration is not needed for this submission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70383","type":"journal-article","created":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:21:10Z","timestamp":1787498470000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sequential High\u2010Dose Ruxolitinib and Low\u2010Dose Splenic Irradiation for Pretransplant Management of Splenomegaly Before Allogeneic Hematopoietic Cell Transplantation With Fludarabine\/Busulfan\u2010Based Conditioning in Myelofibrosis"],"prefix":"10.1002","volume":"7","author":[{"given":"Peng","family":"Ke","sequence":"first","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Feng","sequence":"additional","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqiang","family":"Li","sequence":"additional","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyong","family":"Chen","sequence":"additional","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixuan","family":"Cao","sequence":"additional","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Hu","sequence":"additional","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahe","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linlin","family":"Wang","sequence":"additional","affiliation":[{"name":"The First People's Hospital of Yancheng Affiliated Hospital of Nanjing University Medical School The Yancheng Clinical College of Xuzhou Medical University  Yancheng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.42.0240"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.188"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.146811"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-025-02746-4"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(22)00330-1"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2010.276"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22021"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110556"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27252"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2022.281958"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-06-293415"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.2446"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-12-890889"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018026658"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2022.100964"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2015.09.001"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.12.001"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2021.04.007"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2013.154"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-021-01294-2"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-024-02251-0"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-609032"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2024.03.004"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-018-0169-6"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26020"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26034"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-021-01276-4"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2014.86"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-023-01913-9"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2021.05.016"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.201400"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70383","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jha2.70383","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:43:25Z","timestamp":1791603805000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.70383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/jha2.70383"],"URL":"https:\/\/doi.org\/10.1002\/jha2.70383","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-06-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70383"}}