Ruxolitinib Prior to Transplant in Patients With Myelofibrosis

Inclusion Criteria

• •Documented diagnosis of primary myelofibrosis according to WHO criteria or post PV myelofibrosis or post ET myelofibrosis as per IWG-MRT criteria
• •Age 18-70 years
• •Intermediate-2/ high-risk disease as per Dynamic IPSS (DIPSS) criteria OR Intermediate-1 risk disease with one of the following additional unfavorable features known to impact the survival adversely
• •1. Red cell transfusion dependency
• •2. Unfavorable Karyotype
• •3. Platelet count \<100 x 109/l
• •Blasts in the PB and BM ≤10% prior to study enrollment
• •Availability of a suitable matched related (6/6 or 5/6) or unrelated donor (10/10 or 9/10 antigen or allele matched).
• •Able to give informed written consent
• •ECOG Performance status of 0-2.
• •Life expectancy \>3 months
• •Off all MF-directed therapy including investigational agents for at least 2 weeks prior to study enrollment and recovered from all toxicities\*
• •Adequate organ function
• •* Adequate renal function - creatinine \<1.5 x IULN
• •* Adequate hepatic function - AST/ALT \<2.5 x IULN, Total Bilirubin \<1.5 x IULN
• •* Adequate hematopoietic function - Platelet ≥50 x 109/l and ANC ≥1.0 x 109/l
• •* LVEF \>40% (MUGA or echocardiogram) Normal per Institutional standard
• •* Adequate pulmonary function with DLCO \>50%
• •* A patient who has been on stable dose of Ruxolitinib and has received ruxolitinib ≤6 months prior to the study entry will be considered potentially eligible for the study with the caveat that there is no evidence of loss of response (\>5cm increase in spleen size from the nadir).