The role of molecular risk in predicting survival benefit and guiding transplant decisions in primary MF

Insights into primary myelofibrosis (PMF) driver mutations have led to the development of several classifications for the prediction of OS and transformation to AML, including DIPSS, MIPSS, and MTSS.¹ However, optimal patient selection and timing for transplantation remain unclear.

Paz et al.¹ conducted a cohort study to analyze the potential survival benefit associated with HSCT according to clinicobiological scores, incorporating MIPSS, to facilitate decision-making in this context. Data from a transplant cohort of patients who received transplantation between 2001 and 2022 (n = 239) and a matched non-transplant cohort (n = 105) were used to determine whether patients with PMF and a higher risk molecular score benefit from HSCT. Their findings were published in Blood Advances.¹ 

The survival gain with transplantation in DIPSS intermediate-2 and high-risk patients was +18.6% and +37.9%, respectively. Patients with intermediate MIPSS70 scores achieved an OS benefit with HSCT only if their MTSS scores were low or intermediate.