Ruben A. Mesa, MD, FACP / Jeanne M. Palmer, MD - How to Manage JAK Inhibition in Patients Undergoing HCT: Applying the Latest Clinical Evidence to Improve Patient Outcomes in Myelofibrosis

Go online to PeerView.com/MME860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Myelofibrosis (MF) is a rare myeloproliferative neoplasm which can lead to marrow fibrosis, neo-angiogenesis, and osteosclerosis causing progressive splenomegaly with or without hepatomegaly. Currently, the only potential cure for MF is hematopoietic cell transplantation (HCT). However, the emergence and validation of JAK inhibitors has impacted treatment decisions, including the timing of HCT, and newer evidence suggests that next-generation JAK inhibitors may also play a role in challenging treatment settings defined by failure of upfront JAK inhibitor therapy. Clinicians therefore should be prepared to develop truly personalized, newer therapeutic strategies for MF management that consider all available options—from targeted agents to supportive care, as well as HCT—and address the role of JAK inhibitors in patients who are transplant candidates and determine their role before and, possibly, after transplantation. In this activity based on a recent live web broadcast, a panel of experts describes the current therapeutic landscape of MF, including JAK inhibitors and HCT. They also review evidence supporting the use of first- and second-generation JAK inhibitors and other targeted agents in MF. Upon completion of this activity, participants should be better able to: Describe modern diagnostic and prognostic models, as well as molecular and clinical features that are useful for capturing myelofibrosis (MF) presentations, including primary MF and post-PV/ET MF, Review the current therapeutic role of JAK inhibitors and allogeneic hematopoietic cell transplantation (HCT), including reduced-intensity transplant, in the management of MF, Cite recent safety and efficacy evidence supporting the use of first- and second-generation JAK inhibitors and other targeted agents in the management of MF, Integrate modern JAK inhibitor-based regimens into risk-adapted treatment plans for patients with symptomatic MF, including those who are eligible for allogeneic transplantation or as sequential options in the non-HCT setting.