{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:17:19Z","timestamp":1788970639889,"version":"build-2803163510"},"reference-count":105,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Foundation of Jiangsu Provincial Health Commission","award":["M2024059"],"award-info":[{"award-number":["M2024059"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82341203"],"award-info":[{"award-number":["82341203"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["82341203"],"award-info":[{"award-number":["82341203"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Jiangsu  Province High-Level Hospital Construction Project","award":["LCZX202512"],"award-info":[{"award-number":["LCZX202512"]}]},{"name":"Jiangsu  Province High-Level Hospital Construction Project","award":["SHJDBF2024210"],"award-info":[{"award-number":["SHJDBF2024210"]}]},{"name":"Jiangsu  Province High-Level Hospital Construction Project","award":["GSPJS202417"],"award-info":[{"award-number":["GSPJS202417"]}]},{"name":"Jiangsu  Province High-Level Hospital Construction Project","award":["GSPJS202420"],"award-info":[{"award-number":["GSPJS202420"]}]},{"name":"Jiangsu  Province High-Level Hospital Construction Project","award":["GSPJS202414"],"award-info":[{"award-number":["GSPJS202414"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Myelofibrosis (MF) is a myeloproliferative neoplasm characterized by clonal hematopoietic dysregulation, amplification of chronic inflammation, and progressive remodeling of the bone marrow fibrotic niche, clinically manifesting as bone marrow failure, splenomegaly, and systemic inflammatory symptoms. Although Janus kinase (JAK) inhibitors can alleviate symptom burden and reduce spleen size, they have limited capacity to eradicate malignant clones or reverse fibrosis. Allogeneic hematopoietic stem cell transplantation remains the only potentially curative option; however, its application is constrained by advanced age, comorbidities, unavailable donor, and transplant-related risks. Therefore, the development of disease-modifying therapeutic strategies has become a central focus in MF research. Chimeric antigen receptor T (CAR-T)-cell therapy has demonstrated robust efficacy across various hematologic malignancies. Its application in MF holds the potential not only to selectively eliminate malignant hematopoietic clones but also to modulate the immunosuppressive and profibrotic microenvironment through advanced cellular engineering, thereby enabling a dual therapeutic paradigm involving both clonal control and microenvironmental reprogramming. In this context, potential targets and pathways include CD123, myeloproliferative leukemia protein (MPL), fibroblast activation protein (FAP), the TGF-\u03b2 signaling axis, the CXCR4\u2013CXCL12 niche-regulatory axis, and molecules associated with myeloid-derived suppressor cells (MDSCs) and tumor-associated macrophages (TAMs). Future strategies may optimize both efficacy and safety through combinatorial approaches, including integration with JAK inhibitors, development of armored CAR-T constructs, and bridging to hematopoietic stem cell transplantation. Collectively, CAR-T-cell therapy offers a promising avenue for shifting MF management from symptomatic control toward true disease modification.<\/jats:p>","DOI":"10.3390\/cancers18091493","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T08:01:39Z","timestamp":1778140899000},"page":"1493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prospects of Chimeric Antigen Receptor T-Cell Therapy in Myelofibrosis: From Immunopathogenesis to Therapeutic Strategies"],"prefix":"10.3390","volume":"18","author":[{"given":"Lulu","family":"Kong","sequence":"first","affiliation":[{"name":"The Affiliated Hospital of Xuzhou Medical University, Department of Haematology, Institute of Blood Diseases, Key Laboratory of Bone-Marrow Stem Cells, Xuzhou 221000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunling","family":"Fu","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Xuzhou Medical University, Department of Haematology, Institute of Blood Diseases, Key Laboratory of Bone-Marrow Stem Cells, Xuzhou 221000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianggui","family":"Song","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Xuzhou Medical University, Department of Haematology, Institute of Blood Diseases, Key Laboratory of Bone-Marrow Stem Cells, Xuzhou 221000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxiao","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Xuzhou Medical University, Department of Haematology, Institute of Blood Diseases, Key Laboratory of Bone-Marrow Stem Cells, Xuzhou 221000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengchu","family":"Ji","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Xuzhou Medical University, Department of Haematology, Institute of Blood Diseases, Key Laboratory of Bone-Marrow Stem Cells, Xuzhou 221000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Li","sequence":"additional","affiliation":[{"name":"Clinical Medicine Research Center, Jiangsu Province (Suqian) Hospital, Suqian 223800, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Shi","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Nanjing Medical University, The Second Clinical Medical School of Nanjing Medical University, Nanjing 210011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5480-6577","authenticated-orcid":false,"given":"Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Xuzhou Medical University, Department of Haematology, Institute of Blood Diseases, Key Laboratory of Bone-Marrow Stem Cells, Xuzhou 221000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1182\/blood.2022017423","article-title":"Myelofibrosis","volume":"141","author":"Passamonti","year":"2023","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1002\/ajh.26857","article-title":"Primary myelofibrosis: 2023 update on diagnosis, risk-stratification, and management","volume":"98","author":"Tefferi","year":"2023","journal-title":"Am. 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