Impact of Anemia in MF

Anemia affects nearly all patients with Myelofibrosis

Anemia is a hallmark of Myelofibrosis (MF) and becomes more prevalent as the disease progresses, affecting nearly all patients throughout the course of disease.Sastow D et al. Ther Clin Risk Manag. 2023;19:535-547. Passamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862. Naymagon L, Mascarenhas J. Hemasphere. 2017;1(1):e1.

Although anemia is the most prevalent, >50% of patients present with additional cytopenias at diagnosis.Leukemia & Lymphoma Society. Myeloproliferative Neoplasms: In Detail. Revised 2025. Accessed April 2026. https://llsorg.widen.net/view/pdf/juiq8xkd2b/en-booklet-mpn-detail-ps81.pdf?t.download=true&u=swuzoq

Figure referencesPassamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862. Naymagon L, Mascarenhas J. Hemasphere. 2017;1(1):e1. Leukemia & Lymphoma Society. Myeloproliferative Neoplasms: In Detail. Revised 2025. Accessed April 2026. https://llsorg.widen.net/view/pdf/juiq8xkd2b/en-booklet-mpn-detail-ps81.pdf?t.download=true&u=swuzoq

MF is a myeloproliferative neoplasm (MPN) that can develop de novo as primary MF (PMF) or occur post other MPNs, such as post-polycythemia vera (PPV) or post-essential thrombocythemia (PET).Leukemia & Lymphoma Society. Myeloproliferative Neoplasms: In Detail. Revised 2025. Accessed April 2026. https://llsorg.widen.net/view/pdf/juiq8xkd2b/en-booklet-mpn-detail-ps81.pdf?t.download=true&u=swuzoq

MF is more common with advancing agePrimary myelofibrosis, NOS (PMF). National Cancer Institute. Updated 2026. Accessed March 24, 2026. https://seer.cancer.gov/seertools/hemelymph/51f6cf57e3e27c3994bd5381

1 in 100,000

(0.4 to 1.5 per 100,000 people) in the US were diagnosed with PMF each yearPrimary myelofibrosis, NOS (PMF). National Cancer Institute. Updated 2026. Accessed March 24, 2026. https://seer.cancer.gov/seertools/hemelymph/51f6cf57e3e27c3994bd5381

60-70 years

is the median age range at diagnosis for PMFPrimary myelofibrosis, NOS (PMF). National Cancer Institute. Updated 2026. Accessed March 24, 2026. https://seer.cancer.gov/seertools/hemelymph/51f6cf57e3e27c3994bd5381

54%-60%

of cases are PMF and the rest are PET-/PPV-MFBreccia M et al. Front Oncol. 2024;14:1382872.

Among MPNs, PMF is associated with the lowest survival rates

The development of anemia in MF is multifactorial and is not completely understood, making treatment challenging, and increases risks of mortality.Passamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862.

The 5-year overall survival (OS) rate for PMF is 35%-46%Shallis RM et al. Blood Rev. 2020;42:100706.

Anemia is an important risk factor for morbidity and mortality in MF

Chart showing Higher risk of death in patients with severe anemia (<8 g/dL or transfusion-dependent), compared to that observed for moderate anemia, in both men and women

Adapted from LeukemiaNicolosi M et al. Leukemia. 2018;32(5):1254-1258
^aSurvival data on 1,109 patients with PMF stratified by the degree of anemia.

As one of the major drivers of morbidity and mortality, anemia and transfusion dependence (TD) in MF can lead to reduced quality of life, reduced post-splenectomy survival, increased risk of infection, weakness and fatigue, iron overload, and poor prognosis.Sastow D et al. Ther Clin Risk Manag. 2023;19:535-547. Passamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862. Naymagon L, Mascarenhas J. Hemasphere. 2017;1(1):e1. Leukemia & Lymphoma Society. Myeloproliferative Neoplasms: In Detail. Revised 2025. Accessed April 2026. https://llsorg.widen.net/view/pdf/juiq8xkd2b/en-booklet-mpn-detail-ps81.pdf?t.download=true&u=swuzoq Gerds AT et al. Blood. 2023;142:6418. Nicolosi M et al. Leukemia. 2018;32(5):1254-1258 Tefferi A et al. Mayo Clin Proc. 2012;87(1):25-33.

Transfusion-dependent anemia is a risk factor for leukemic transformation and a poor prognostic factor:McKinnell Z et al. J Hematol. 2022 Dec;11(6):197-209. Tefferi A et al. Leukemia. 2018;32(5):1200-1210.

Leukemic transformation was observed as the most common cause of death for patients with MF in a single cohortElena C et al. Haematologica. 2011;96(1):167-170.
10%-20% of patients with MF go on to develop AML within 10 yearsTefferi A et al. Leukemia. 2018;32(5):1200-1210. Garmezy B et al. Blood Rev. 2021;45:100691
Post-MPN AML can lead to a poor prognosis, with an observed median OS reported to be 3.6 monthsTefferi A et al. Leukemia. 2018;32(5):1200-1210.

Transfusion dependence negatively impacts the survival of patients with MFNaymagon L, Mascarenhas J. Hemasphere. 2017;1(1):e1. Elena C et al. Haematologica. 2011;96(1):167-170.

Figure referencesSastow D et al. Ther Clin Risk Manag. 2023;19:535-547. Passamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862. Naymagon L, Mascarenhas J. Hemasphere. 2017;1(1):e1. Tefferi A et al. Mayo Clin Proc. 2012;87(1):25-33.

The median OS for patients who were transfusion-dependent at diagnosis was 2.6 years, compared with 8 years in those who were TI (HR 3.9; 95% CI: 2.5-6.1; P<0.001)Elena C et al. Haematologica. 2011;96(1):167-170.
Patients who are transfusion-dependent have significantly worse OS vs patients who remain TI throughout treatment (HR 7.8; 95% CI: 5.1-11.9; P<0.001)Elena C et al. Haematologica. 2011;96(1):167-170.

Reproduced with permission from HematologicaElena C et al. Haematologica. 2011;96(1):167-170.
^cIn 288 patients with PMF; ^dIn 220 regularly followed patients with PMF.

Living with MF can place a heavy burden on many patients' daily lives

Several studies have shown that the quality of life in patients with MF is significantly worse than the general population.Mesa RA et al. Hemasphere. 2023;7(11):e966. Mesa R et al. BMC Cancer 2016;16:167. Harrison CN et al. Ann Hematol. 2017;96(10):1653-1665.

This impact is driven by a profound symptomatic burden caused by both disease manifestations (eg, anemia, splenomegaly) and patient‑reported experiences, that may include fatigue, bone pain, discomfort, etc.Mesa RA et al. Hemasphere. 2023;7(11):e966. Mesa R et al. BMC Cancer 2016;16:167. Harrison CN et al. Ann Hematol. 2017;96(10):1653-1665.

Physical

Fatigue is the most reported symptom and main barrier to physical activity, with the presence of anemia being correlated with a stepwise increase in fatiguePassamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862. Mesa RA et al. Hemasphere. 2023;7(11):e966.
Sleep habits may also be disturbed, contributing to further fatigueMesa R et al. BMC Cancer 2016;16:167.

Emotional

Fatigue can interfere with daily activities and limit family or social life, having a negative impact on the patient's emotional well-beingMesa RA et al. Hemasphere. 2023;7(11):e966.
Patients with MF reported feeling anxious or worried (91%), depressed (75%), or angry (43%) about their diseaseMesa R et al. BMC Cancer 2016;16:167.

Role Functioning

Patients with MF and fatigue report decreases in work productivity, reduced working hours, less sick leave, higher rates of absenteeism, and ultimately job termination Mesa RA et al. Hemasphere. 2023;7(11):e966. Mesa R et al. BMC Cancer 2016;16:167. Harrison CN et al. Ann Hematol. 2017;96(10):1653-1665.

Social Functioning

Many patients also report their disease having a negative impact on relationships with family members (79%), with caregivers (28%), and in other social settings, such as in their sex lives (63%)Mesa R et al. BMC Cancer 2016;16:167.