Improved Transplant Outcomes With Alternative Donors in Myelofibrosis: A 20‐Year Japanese Registry Analysis of Donor Sources and the Impact of Ruxolitinib

This study of 308 myelofibrosis patients shows that in recent years (2013-2019), alternative donors (mismatched unrelated donors and cord blood) achieved survival rates comparable to HLA-matched donors-a significant improvement compared to earlier years (2000-2012) when outcomes differed substantially. Ruxolitinib showed significant benefits in older patients (≥ 57), particularly with mismatched unrelated donors. Cord blood transplantation outcomes improved with MMF-based GVHD prophylaxis. These findings suggest optimized strategies combining both age-specific and donor-specific approaches can maximize transplant success in myelofibrosis patients.