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MPN Workshop of the Carolinas 2025 | Further optimizing conditioning regimens for patients with MPNs to improve transplant outcomes
In this video, Uday Popat, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, highlights that future developments could further optimize conditioning approaches for patients with myeloproliferative neoplasms (MPNs) undergoing transplant. Prof. Popat suggests that shrinking the spleen aggressively could help achieve this, and that this may potentially be accomplished by adding high-dose ruxolitinib to the conditioning regimen. This interview took place at the 2nd Annual MPN Workshop of the Carolinas, held in Charlotte, NC.
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Transcript
For MPN patients, I think the biggest challenge is that these patients have a big spleen. And patients with a big spleen after transplant with a myeloablative regimen, they do engraft, but we do end up with poor graft function. And what I mean by that is their neutrophil or platelets or hemoglobin are lower and they’re transfusion dependent. And this can go on for a long period of time...
For MPN patients, I think the biggest challenge is that these patients have a big spleen. And patients with a big spleen after transplant with a myeloablative regimen, they do engraft, but we do end up with poor graft function. And what I mean by that is their neutrophil or platelets or hemoglobin are lower and they’re transfusion dependent. And this can go on for a long period of time. In fact, poor graft function is present at day 100 in about a quarter of the patients. And to fix that, we think shrinking the spleen aggressively with the conditioning regimen may be the way to go. So what we are studying is adding high-dose ruxolitinib, 100 milligrams a day, as part of the conditioning regimen. And that, I suppose, if we can optimize that, that may help further improve outcomes.
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Disclosures
Consultancy: TScan Therapeutics, Medscape, Illuminate Health, Daiichi Sankyo, Binaytara Foundation, South Piedmont Area Health Education Center (AHEC), MD Education Limited; Scientific Advisory Board: TScan Therapeutics, Medscape, Illuminate Health, Daiichi Sankyo, Binaytara Foundation, South Piedmont Area Health Education Center (AHEC), MD Education Limited; Speaker Fees: TScan Therapeutics, Medscape, Illuminate Health, Daiichi Sankyo, Binaytara Foundation, South Piedmont Area Health Education Center (AHEC), MD Education Limited; Professional Society Activities: American Society for Transplantation and Cellular Therapy (ASTCT).
