Recent Advances in the Management of Myelofibrosis

Aaron T. Gerds, MD, MS, details the current treatment options available for patients with high-risk myelofibrosis, and reviews the criteria for risk stratification.

Aaron T. Gerds, MD, MS, explains the current remaining unmet needs in the treatment of patients with myelofibrosis.

Aaron T. Gerds, MD, MS, highlights exciting treatment options on the horizon for patients with myelofibrosis.

Aaron Gerds, MD, MS, presents the case of a 73-year-old man with myelofibrosis.

Aaron Gerds, MD, MS, explains that unlike solid tumors, blood cancers are systemic, so risk stratification models like DIPSS that use readily available data on blood counts and physical exam are more useful prognostically; however, mutation analysis is becoming increasingly important for determining prognosis and targeting therapies.

Aaron Gerds, MD, MS, outlines how first-line treatment choice for myelofibrosis depends on symptoms, spleen size, and blood counts, while second-line choice depends on prior side effects and medical history.

Aaron Gerds, MD, MS, details the use of momelotinib in myelofibrosis treatment.

Aaron Gerds, MD, MS, explains that myelofibrosis patients on JAK inhibitors need regular monitoring of blood counts, liver enzymes, and cardiac events to check for reactivation.

When switching JAK inhibitors for myelofibrosis, Aaron Gerds, MD, MS, advises stopping ruxolitinib and starting the new JAK inhibitor the next day due to its short half-life, though tapering ruxolitinib over 1 week is recommended for patients on higher doses to avoid rebound symptoms; pacritinib and fedratinib have longer half-lives so a 1-week washout can be considered.

Aaron Gerds, MD, MS, explains the factors to consider when selecting an appropriate JAK inhibitor for patients with myelofibrosis.

Aaron Gerds, MD, MS, reviews key safety concerns seen with JAK inhibitors for myelofibrosis treatment.

Aaron Gerds, MD, MS, shares hopes that combination therapies now in trials, along with other novel approaches further down the pipeline like monoclonal antibodies, vaccines, and cellular therapies will likely radically advance treatment over the next 5 to 10 years.