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These are clinically diverse disorders and present many challenges during their course, ranging from the management of very indolent, chronic\u2010phase disease through to very aggressive stages frequently associated with poor quality of life, heavy symptom burdens and potentially life expectancies of &lt;18\u00a0months. Their management also requires expertise in thrombosis and haemostasis in addition to marrow failure, debilitating symptom control and balancing the \u2018pros and cons\u2019 of intensive therapy such as allogeneic stem cell transplant <jats:italic>versus<\/jats:italic> novel and established therapies. In the past 15\u00a0years this field has seen rapid advances following an understanding of the pivotal importance of constitutive Janus kinase\/signal transducers and activators of transcription (JAK\/STAT) signalling, the interplay of the wider genomic landscape and the development of updated diagnostic criteria, prognostic scores and targeted therapies. In this article, we review the successes and failures of novel agents and approaches to MPN management.<\/jats:p>","DOI":"10.1111\/bjh.16573","type":"journal-article","created":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T13:41:35Z","timestamp":1584106895000},"page":"21-36","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Forging ahead or moving back: dilemmas and disappointments of novel agents for myeloproliferative neoplasms"],"prefix":"10.1111","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1224-091X","authenticated-orcid":false,"given":"Donal P.","family":"McLornan","sequence":"first","affiliation":[{"name":"Department of Haematology 4th Floor Southwark Wing Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3212-920X","authenticated-orcid":false,"given":"Claire N.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Haematology 4th Floor Southwark Wing Guy\u2019s and St. Thomas\u2019 NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,13]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.143677"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.4155\/fsoa-2018-0115"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.146654"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12416"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-09-740092"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21754"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-01-478891"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcmm.12162"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-99-113332"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71142-9"},{"key":"e_1_2_14_13_1","unstructured":"Celgene Corporation. 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