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<p>Myelodysplastic/myeloproliferative neoplasms (excluding CMML) are rare and heterogenous malignancies with recurrent and overlapping clinicopathological abnormalities. Classification and characterization continue to evolve, but outcomes remain unsatisfactory and allo-HCT is currently the only curative therapy. Experience with these diseases is limited by rarity, accounting for &lt;1% of allo-HCT procedures in Europe annually. Transplant indications have recently been described by this group, however response assessment, post-transplant surveillance and management of poor graft function, splenomegaly and relapse are not well established. To address this gap, the European Society for Blood and Marrow Transplantation (EBMT) Practice Harmonization &amp; Guidelines (PH&amp;G) Committee and the Chronic Malignancies Working Party (CMWP) collaborated to develop a practical and expert consensus-based guideline. Criteria for remission confirmation are proposed, including timing/thresholds for morphological, molecular, cytogenetic and chimerism analysis, aiming to harmonize comparisons in registry data and between international series. Suggestions for managing poor graft function and splenomegaly are designed to broadly align with those for myelofibrosis and related disorders. Relapse post-transplant remains a frequent challenge and the lack of robust evidence, in both the pre-transplant/post-transplant setting, underpins a need for collaborative clinical trials. This document serves as a framework to model post-transplant care, guide future research and address unresolved questions.</p>

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Defining remission and relapse after allogeneic hematopoietic cell transplantation in myelodysplastic/myeloproliferative neoplasms and optimization of transplantation outcomes: Recommendations from the EBMT practice harmonisation and guidelines committee

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Christopher Armstrong,
  • Kavita Raj,
  • Giorgia Battipaglia,
  • Gonzalo Bentolila,
  • Eolia Brissot,
  • Yves Chalandon,
  • Fernando Barroso Duarte,
  • Joanna Drozd-Sokolowska,
  • Vaneuza Funke,
  • Nico Gagelmann,
  • Thierry Guillaume,
  • Carmelo Gurnari,
  • Robert Hasserjian,
  • Juan Carlos Hernández-Boluda,
  • Devendra Hiwase,
  • Andrés Jerez,
  • Michael Loschi,
  • Marin Medjugorac,
  • Mufaddal T. Moonim,
  • Francesco Onida,
  • Nicola Polverelli,
  • Micaela Quarchioni,
  • Marie Robin,
  • Christof Scheid,
  • Katja Sockel,
  • Daniel H. Wiseman,
  • Annalisa Ruggeri,
  • Isabel Sánchez-Ortega,
  • Natalia Aranguiz Garcia,
  • Mario Cazzola,
  • Fabio Ciceri,
  • Tomasz Czerw,
  • Jaroslaw Maciejewski,
  • Simona Pagliuca,
  • Lisa Pleyer,
  • Patryk Sobieralski,
  • Jurjen Versluis,
  • Maria Teresa Voso,
  • Ibrahim Yakoub-Agha,
  • Donal P. McLornan

摘要

Myelodysplastic/myeloproliferative neoplasms (excluding CMML) are rare and heterogenous malignancies with recurrent and overlapping clinicopathological abnormalities. Classification and characterization continue to evolve, but outcomes remain unsatisfactory and allo-HCT is currently the only curative therapy. Experience with these diseases is limited by rarity, accounting for <1% of allo-HCT procedures in Europe annually. Transplant indications have recently been described by this group, however response assessment, post-transplant surveillance and management of poor graft function, splenomegaly and relapse are not well established. To address this gap, the European Society for Blood and Marrow Transplantation (EBMT) Practice Harmonization & Guidelines (PH&G) Committee and the Chronic Malignancies Working Party (CMWP) collaborated to develop a practical and expert consensus-based guideline. Criteria for remission confirmation are proposed, including timing/thresholds for morphological, molecular, cytogenetic and chimerism analysis, aiming to harmonize comparisons in registry data and between international series. Suggestions for managing poor graft function and splenomegaly are designed to broadly align with those for myelofibrosis and related disorders. Relapse post-transplant remains a frequent challenge and the lack of robust evidence, in both the pre-transplant/post-transplant setting, underpins a need for collaborative clinical trials. This document serves as a framework to model post-transplant care, guide future research and address unresolved questions.