The Intricate Dance Between Inflammation and Myeloproliferative Neoplasms: From Origins to Outcomes.

PURPOSE OF REVIEW: Myeloproliferative neoplasms (MPNs) lie at the intersection of malignancy and chronic inflammatory disease. This review summarizes current understanding of how inflammation drives MPN pathogenesis, from clonal initiation to progression and symptom burden, and explores how emerging therapies modulate the inflammatory microenvironment.

RECENT FINDINGS: Evidence from human genetics, epidemiology, and experimental models shows that chronic inflammatory stress promotes the expansion of JAK2- and other MPN-associated clones. Inflammatory cytokine networks sustain myeloproliferation, reshape the bone marrow niche, and contribute to fibrosis. JAK inhibitors remain the cornerstone of therapy and exert much of their clinical benefit through suppression of cytokine signaling. Newer agents also mitigate inflammation through complementary mechanisms. Inflammation is inseparable from MPN biology and represents both a driver and a therapeutic target. Reframing MPN as a disorder of maladaptive immune and stromal interactions highlights opportunities to restore balance within this ecosystem and potentially alter disease course.