TNF and myeloproliferative neoplasm: Furthermore, MPN-BM-MSCs promote an abnormal generation of osteoblast-like inflammatory “myelofibrotic” cells, as a result of a dysregulated inflammatory milieu due to elevated TGF-β1, Notch, IL-6, IL-1β, and TNF-α production, which may be a consequence of direct contact between MPN-HSCs and BM-MSCs [216].