Managing Myelofibrosis Patients With Anemia

Abdulraheem Yacoub, MD, provides an overview of myelofibrosis, including diagnosis via bone marrow examination, clinical criteria, and risk stratification using prognostic models to determine appropriate therapy.

Treatment goals for patients with myelofibrosis include prolonged survival and improved quality of life, with decision-making incorporating risk level, transplant eligibility, toxicity, and clinical trial data to select among the available JAK inhibitors.

Abdulraheem Yacoub, MD, reviews the current myelofibrosis treatment landscape including the four approved JAK inhibitors - ruxolitinib, fedratinib, pacritinib, and momelotinib - discussing the clinical trial data and indications for each in first-line and second-line settings.

Dr Abdulraheem Yacoub discusses experience with the JAK inhibitor momelotinib in patients with myelofibrosis, noting robust efficacy in clinical trials for spleen volume reduction, symptom improvement, and anemia benefit, but explains that its utility in first-line versus second-line settings is still being determined.

Severe anemia in myelofibrosis is defined as hemoglobin under 8 g/dL or transfusion dependence, requiring management with JAK inhibitors, erythropoietin stimulating agents, or danazol, given its impact on patient prognosis.

Abdulraheem Yacoub, MD, closes by sharing that the myelofibrosis treatment landscape is expected to evolve in the coming years with results to come from clinical trials investigating combination therapies, novel agents, and targeted approaches for disease progression and improving durability of response.