Nontransplant Treatment Options for Myelofibrosis: How to Treat Anemia, Splenomegaly, Constitutional Symptoms, and Extramedullary Disease

摘要: Current drug therapy in PMF is not curative and has been shown to prolong survival. Allogenic stem cell transplant (ASCT) potentially but also associated with relatively high risk of death morbidity. Therefore, one must first determine if a particular patient needs any form carefully select the treatment strategy best chance inducing disease control without compromising life expectancy (Table 15.1 Fig. 15.1). According DIPSS-plus prognostic model (Gangat et al. 2011), respective median survival low- or intermediate-1-risk patients exceeds 15 6 years even longer for below age 65 years. allo-SCT-associated mortality morbidity justified such patients. Similarly, there no evidence support value conventional asymptomatic disease. “watch wait” reasonable usually preferred intermediate-risk MF. MF high- intermediate-2-risk are symptomatic can be managed by therapy, splenectomy, radiotherapy, allo-SCT, experimental (Fig. The goal using allo-SCT cure prolongation life. nontransplant candidates palliation.