{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:43:06Z","timestamp":1787071386926,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Allogeneic hematopoietic cell transplant (allo-HCT) is the only potentially curative treatment for myelofibrosis (MF) and chronic myelomonocytic leukemia (CMML). Older age, comorbidities, and often advanced disease make patient selection and optimal transplant timing challenging. This study sought to understand allo-HCT outcomes for these myeloproliferative neoplasms in a contemporary era, including molecular data, to define a uniform transplant approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis was performed on patients with MF or CMML who received allo-HCT at the Cleveland Clinic between January 1, 2010 and April 1, 2023. All donor types and graft sources were included. MF and CMML outcomes were analyzed separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-nine MF and 33 CMML patients were included.\n                      <jats:italic toggle=\"yes\">JAK2<\/jats:italic>\n                      V617F was detected in 57.6% of MF patients; only 34 (57.6%) had next-generation sequencing (NGS) performed. Most MF transplants were reduced intensity (RIC; 69.5%) and peripheral blood stem cell (PBSC; 91%). At median follow-up of 41 months, 28\/59 (47.5%) MF patients were alive. MF patients who were\n                      <jats:italic toggle=\"yes\">JAK2<\/jats:italic>\n                      + with additional cytogenetic changes or concurrent mutations had better overall survival. In CMML, 69.7% had myeloid NGS, with\n                      <jats:italic toggle=\"yes\">ASXL1<\/jats:italic>\n                      identified in 51.9% of cases. Most transplants were RIC (66.7%) and PBSC (72.7%). At median follow-up of 46.8 mos, 13\/33 (39.4%) patients were alive. Relapse accounted for 9\/20 CMML deaths; 8 of these received RIC. Mutational signature did not significantly impact survival, though the presence of any cytogenetic aberrancy was associated with worse OS (12 mos, 95% CI, 7.13\u2013NA vs. 24.2 mos, 9.6\u2013NA;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.19).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For MF and CMML, older patients (\u226565) and RIC transplants trended toward worse survival. Strategies to reduce relapse and optimize patient selection utilizing molecular and cytogenetic data should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/hemoncstem.hemoncstem-d-25-00008","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T09:01:04Z","timestamp":1757667664000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Myeloablative and Reduced Intensity Allogeneic Transplant in Patients with Myeloproliferative Neoplasms"],"prefix":"10.4103","author":[{"given":"Andrew D.","family":"Trunk","sequence":"first","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Quantitative Health Science, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron T.","family":"Gerds","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akriti","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudipto","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Balderman","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetty","family":"Carraway","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betty K.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Sobecks","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Kalaycio","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Sauter","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Brunstein","sequence":"additional","affiliation":[{"name":"Blood and Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"R1-20250912","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1080\/10428190802304974","article-title":"Allogeneic hematopoietic cell transplantation for Hodgkin lymphoma: a concise review","volume":"49","author":"Laport","year":"2008","journal-title":"Leuk Lymphoma"},{"key":"R2-20250912","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":"R3-20250912","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1001\/jamaoncol.2015.89","article-title":"Myeloproliferative neoplasms: a contemporary review","volume":"1","author":"Tefferi","year":"2015","journal-title":"JAMA Oncol"},{"key":"R4-20250912","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.3324\/haematol.2019.222059","article-title":"Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions","volume":"104","author":"Valent","year":"2019","journal-title":"Haematologica"},{"key":"R5-20250912","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s12185-017-2243-z","article-title":"CMML: clinical and molecular aspects","volume":"105","author":"Itzykson","year":"2017","journal-title":"Int J Hematol"},{"key":"R6-20250912","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1038\/leu.2013.119","article-title":"Mutations and prognosis in primary myelofibrosis","volume":"27","author":"Vannucchi","year":"2013","journal-title":"Leukemia"},{"key":"R7-20250912","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/bjh.19164","article-title":"Diagnosis and evaluation of prognosis of myelofibrosis: a British Society for Haematology Guideline","volume":"204","author":"McLornan","year":"2024","journal-title":"Br J Haematol"},{"key":"R8-20250912","doi-asserted-by":"crossref","first-page":"e393","DOI":"10.1038\/bcj.2016.5","article-title":"Cytogenetic and molecular abnormalities in chronic myelomonocytic leukemia","volume":"6","author":"Patnaik","year":"2016","journal-title":"Blood Cancer J"},{"key":"R9-20250912","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1002\/ajh.26455","article-title":"Chronic myelomonocytic leukemia: 2022 update on diagnosis, risk stratification, and management","volume":"97","author":"Patnaik","year":"2022","journal-title":"Am J Hematol"},{"issue":"(20)","key":"R10-20250912","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"key":"R11-20250912","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/j.leukres.2012.04.021","article-title":"Allogeneic stem cell transplantation for myeloproliferative neoplasm in blast phase","volume":"36","author":"Cherington","year":"2012","journal-title":"Leuk Res"},{"key":"R12-20250912","doi-asserted-by":"crossref","first-page":"3494","DOI":"10.1182\/blood-2010-11-315614","article-title":"How I treat myelofibrosis","volume":"117","author":"Tefferi","year":"2011","journal-title":"Blood"},{"key":"R13-20250912","doi-asserted-by":"crossref","first-page":"659","DOI":"10.3324\/haematol.2018.206151","article-title":"State-of-the-art review: allogeneic stem cell transplantation for myelofibrosis in 2019","volume":"104","author":"McLornan","year":"2019","journal-title":"Haematologica"},{"key":"R14-20250912","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1016\/j.bbmt.2017.05.007","article-title":"Allogeneic stem cell transplantation in myelofibrosis","volume":"23","author":"Jain","year":"2017","journal-title":"Biol Blood Marrow Transplant"},{"key":"R15-20250912","doi-asserted-by":"crossref","first-page":"3912","DOI":"10.1182\/blood-2003-06-1856","article-title":"Allogeneic hematopoietic stem cell transplantation for myelofibrosis","volume":"102","author":"Deeg","year":"2003","journal-title":"Blood"},{"key":"R16-20250912","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1182\/blood.2021015173","article-title":"Role of allogeneic transplantation in chronic myelomonocytic leukemia: an international collaborative analysis","volume":"140","author":"Robin","year":"2022","journal-title":"Blood"},{"key":"R17-20250912","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.bbmt.2017.01.078","article-title":"Allogeneic hematopoietic cell transplantation for adult chronic myelomonocytic leukemia","volume":"23","author":"Liu","year":"2017","journal-title":"Biol Blood Marrow Transplant"},{"key":"R18-20250912","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1002\/ajh.25053","article-title":"Allogeneic hematopoietic stem cell transplant overcomes the adverse survival effect of very high risk and unfavorable karyotype in myelofibrosis","volume":"93","author":"Tefferi","year":"2018","journal-title":"Am J Hematol"},{"key":"R19-20250912","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1182\/bloodadvances.2019001084","article-title":"Survival following allogeneic transplant in patients with myelofibrosis","volume":"4","author":"Gowin","year":"2020","journal-title":"Blood Adv"},{"key":"R20-20250912","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1182\/blood-2012-05-399048","article-title":"Allogeneic hematopoietic cell transplantation for myelofibrosis in the era of JAK inhibitors","volume":"120","author":"Gupta","year":"2012","journal-title":"Blood"},{"key":"R21-20250912","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.bbmt.2009.10.025","article-title":"Outcome of transplantation for myelofibrosis","volume":"16","author":"Ballen","year":"2010","journal-title":"Biol Blood Marrow Transplant"},{"key":"R22-20250912","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.3324\/haematol.2022.281958","article-title":"Association between the choice of the conditioning regimen and outcomes of allogeneic hematopoietic cell transplantation for myelofibrosis","volume":"108","author":"Murthy","year":"2023","journal-title":"Haematologica"},{"key":"R23-20250912","doi-asserted-by":"crossref","first-page":"637512","DOI":"10.3389\/fimmu.2021.637512","article-title":"Allogeneic hemopoietic stem cell transplantation for myelofibrosis: 2021","volume":"12","author":"Bacigalupo","year":"2021","journal-title":"Front Immunol"},{"key":"R24-20250912","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1038\/s41375-020-0815-z","article-title":"Determinants of survival in myelofibrosis patients undergoing allogeneic hematopoietic cell transplantation","volume":"35","author":"Hernandez-Boluda","year":"2021","journal-title":"Leukemia"},{"key":"R25-20250912","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1080\/1042819042000207271","article-title":"Risk assessment in chronic myelomonocytic leukemia (CMML)","volume":"45","author":"Germing","year":"2004","journal-title":"Leuk Lymphoma"},{"key":"R26-20250912","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/ajh.25684","article-title":"Chronic myelomonocytic leukemia: 2020 update on diagnosis, risk stratification and management","volume":"95","author":"Patnaik","year":"2020","journal-title":"Am J Hematol"},{"key":"R27-20250912","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1182\/blood.2023023476","article-title":"Management of adult patients with CMML undergoing allo-HCT: recommendations from the EBMT PH&G Committee","volume":"143","author":"Onida","year":"2024","journal-title":"Blood"},{"key":"R28-20250912","doi-asserted-by":"crossref","first-page":"991e1","DOI":"10.1016\/j.jtct.2021.08.028","article-title":"Allogeneic hematopoietic stem cell transplantation for chronic myelomonocytic leukemia: clinical and molecular genetic prognostic factors in a Nordic population","volume":"27","author":"Wedge","year":"2021","journal-title":"Transplant Cell Ther"},{"key":"R29-20250912","doi-asserted-by":"crossref","first-page":"3328","DOI":"10.1200\/JCO.20.03380","article-title":"Biologic assignment trial of reduced-intensity hematopoietic cell transplantation based on donor availability in patients 50-75 years of age with advanced myelodysplastic syndrome","volume":"39","author":"Nakamura","year":"2021","journal-title":"J Clin Oncol"},{"key":"R30-20250912","doi-asserted-by":"crossref","first-page":"4281","DOI":"10.1182\/bloodadvances.2024013451","article-title":"Donor types and outcomes of transplantation in myelofibrosis: a CIBMTR study","volume":"8","author":"Jain","year":"2024","journal-title":"Blood Adv"},{"key":"R31-20250912","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1016\/j.bbmt.2019.06.034","article-title":"Myeloablative and reduced-intensity conditioned allogeneic hematopoietic stem cell transplantation in myelofibrosis: a retrospective study by the chronic malignancies working party of the European society for blood and marrow transplantation","volume":"25","author":"McLornan","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"R32-20250912","doi-asserted-by":"crossref","first-page":"3005","DOI":"10.1182\/blood-2012-08-452938","article-title":"Development and validation of a prognostic scoring system for patients with chronic myelomonocytic leukemia","volume":"121","author":"Such","year":"2013","journal-title":"Blood"},{"key":"R33-20250912","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1756-8722-5-12","article-title":"Mutations in ASXL1 are associated with poor prognosis across the spectrum of malignant myeloid diseases","volume":"5","author":"Gelsi-Boyer","year":"2012","journal-title":"J Hematol Oncol"},{"key":"R34-20250912","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1182\/blood-2010-06-293415","article-title":"Dynamic International Prognostic Scoring System (DIPSS) predicts progression to acute myeloid leukemia in primary myelofibrosis","volume":"116","author":"Passamonti","year":"2010","journal-title":"Blood"},{"key":"R35-20250912","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1200\/JCO.2010.32.2446","article-title":"DIPSS plus: a refined Dynamic International Prognostic Scoring System for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count, and transfusion status","volume":"29","author":"Gangat","year":"2011","journal-title":"J Clin Oncol"},{"key":"R36-20250912","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1200\/JCO.2018.78.9867","article-title":"MIPSS70+ Version 2.0: mutation and karyotype-enhanced international prognostic scoring system for primary myelofibrosis","volume":"36","author":"Tefferi","year":"2018","journal-title":"J Clin Oncol"},{"key":"R37-20250912","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/bjh.16380","article-title":"Mutation-enhanced international prognostic systems for essential thrombocythaemia and polycythaemia vera","volume":"189","author":"Tefferi","year":"2020","journal-title":"Br J Haematol"},{"issue":"(6)","key":"R38-20250912","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1182\/bloodadvances.2020003600","article-title":"A prognostic score including mutation profile and clinical features for patients with CMML undergoing stem cell transplantation","volume":"5","author":"Gagelmann","year":"2021","journal-title":"Blood Adv"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.HEMONCSTEM-D-25-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:45:21Z","timestamp":1787067921000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.HEMONCSTEM-D-25-00008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":38,"URL":"https:\/\/doi.org\/10.4103\/hemoncstem.hemoncstem-d-25-00008","relation":{},"ISSN":["1658-3876","2589-0646"],"issn-type":[{"value":"1658-3876","type":"print"},{"value":"2589-0646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]},"assertion":[{"value":"2025-03-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}