Dr. Saint Fleur-Lominy on the Role of Transplant in MPNs

Shella Saint Fleur-Lominy, MD, PhD, an assistant professor in the Department of Medicine at NYU Langone Health’s Perlmutter Cancer Center, discusses the role of transplant in myeloproliferative neoplasms (MPNs).

Currently, allogeneic stem cell transplant (allo-SCT) is the only curative option for patients with MPNs, says Saint Fleur-Lominy. JAK2 inhibitors can aid in symptom management to make patients more comfortable. Although there is some evidence that ruxolitinib (Jakafi) may also improve survival, the agent does not have a good disease-modifying effect.

Allo-SCT may be considered for patients with intermediate- or high-risk MPNs who don’t have significant comorbidities, says Saint Fleur-Lominy. The age of the patient could also influence transplant eligibility.

Eligible patients should be considered for transplant upfront, after which a JAK inhibitor can be considered upon relapse or progression. If a patient is asymptomatic, they can defer transplant until they develop symptoms, concludes Saint Fleur-Lominy.