Peri-Transplant Gecacitinib in Patients With Myelofibrosis Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

This study aims to evaluate the efficacy, safety, and feasibility of peri-transplant gecacitinib in patients with myelofibrosis undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Myelofibrosis is a bone marrow disorder that can cause reduced blood cell production, enlargement of the spleen, and other complications. Allogeneic stem cell transplantation offers a potential cure, but its benefits may be limited by graft-versus-host disease (GVHD), disease relapse, and transplant-related complications. This is a multicenter, prospective, open-label, single-arm clinical study. Participants will receive gecacitinib before, during, and after transplantation, together with standard transplantation care and GVHD prophylaxis. The primary objective is to evaluate GVHD-free, relapse-free survival (GRFS) at 1 year after transplantation. GRFS measures survival without severe acute GVHD, chronic GVHD requiring systemic immunosuppressive treatment, disease relapse or progression, or death. The study plans to enroll approximately 46 participants, with 43 expected to be evaluable for the primary endpoint. Participants will be followed for up to 2 years after transplantation. Secondary assessments include overall survival, progression-free survival, GVHD, disease relapse, non-relapse mortality, hematopoietic engraftment, treatment feasibility, and safety.