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Myelofibrosis is a progressive disease that culminates in fatal cytopenias or leukemic transformation. The only curative therapy is allogeneic hematopoietic stem-cell transplantation (AHSCT), but the feasibility of this approach in older patients has been unclear.
To examine the safety and effectiveness of reduced-intensity AHSCT in this setting, investigators conducted a prospective, multicenter, phase II study involving 66 patients with primary myelofibrosis (median age, 55; range 30–65; about half had JAK2 V617F mutation); 32 had sibling donors, and 34 had unrelated donors. All patients received fludarabine and melphalan for conditioning. Those receiving grafts from unrelated donors also received rabbit antithymocyte globulin. Graft-versu…