Goals of Treatment in MF-Associated Anemia
Treatment overview
Treatment for myelofibrosis (MF) is personalized based on disease characteristics, symptom burden, and risk of progression. The presence of anemia is a key factor that impacts management of patients with MF.Vachhani P et al. Haematologica. 2026;111(4):1179-1197. Jain AG, Gerds AT. Blood. 2025;145(16):1738-1746. Tefferi A. Am J Hematol. 2023;98(5):801-821. Passamonti F, Mora B. Blood. 2023;141(16):1954-1970. Verstovsek S. Ann Hematol. 2023;102(4):689-698.
Because anemia frequently arises during the course of MF and is associated with increased morbidity and mortality, timely recognition and management is an important part of a comprehensive treatment approach.Vachhani P et al. Haematologica. 2026;111(4):1179-1197. Verstovsek S. Ann Hematol. 2023;102(4):689-698. Al-Ali HK et al. Cancers (Basel). 2024;16(23):4064. Passamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862
Treatment of MF-associated anemia
Overall, the treatment approach for patients with anemia associated with MF depends on which of the following best describes their ongoing symptoms and response to treatment:Jain AG, Gerds AT. Blood. 2025;145(16):1738-1746. Verstovsek S. Ann Hematol. 2023;102(4):689-698. Myeloproliferative neoplasms (MPNs). Blood Cancer United. Accessed April 2, 2026. https://bloodcancerunited.org/blood-cancer/myeloproliferative-neoplasms-mpns Garmezy B et al. Blood Rev. 2021;45:100691.
Anemia without splenomegaly or constitutional symptoms of MF
Anemia with other symptoms of MF that are well controlled by ongoing Janus kinase inhibitor (JAKi) therapy
Anemia with other symptoms of MF that are not well controlled by ongoing JAKi therapy
Treatment modalities in MF-associated anemia
Patients with MF-associated anemia should be monitored closely to guide treatment decisions. Management may involve supportive care, active treatment, transplant, or a combination of these. As there are currently no drug therapies that can cure MF, supportive care and active treatments focus on limiting the symptoms and complications of the disease.Vachhani P et al. Haematologica. 2026;111(4):1179-1197. Tefferi A. Am J Hematol. 2023;98(5):801-821. Verstovsek S. Ann Hematol. 2023;102(4):689-698. Myeloproliferative neoplasms (MPNs). Blood Cancer United. Accessed April 2, 2026. https://bloodcancerunited.org/blood-cancer/myeloproliferative-neoplasms-mpns Garmezy B et al. Blood Rev. 2021;45:100691.
Supportive care
Supportive care encompasses monitoring the disease and may include using nonpharmacologic approaches to mitigate the burden of its symptoms.Tefferi A. Am J Hematol. 2023;98(5):801-821. Verstovsek S. Ann Hematol. 2023;102(4):689-698. Myeloproliferative neoplasms (MPNs). Blood Cancer United. Accessed April 2, 2026. https://bloodcancerunited.org/blood-cancer/myeloproliferative-neoplasms-mpns Brennan-Cook J et al. J Palliat Med. 2025;28(2):257-264. Yoon J, Pettit K. Expert Rev Hematol. 2021;14(7):607-619. Therapy, counseling, and support resources for people with cancer. American Cancer Society. Accessed April 9, 2026. https://www.cancer.org/cancer/supportive-care/therapy-counseling-and-support-resources.html
Modalities include
- Clinical monitoring and assessment
- Lifestyle modifications
- Psychosocial support
- Transfusions
Active treatments
Active treatments for patients with MF-associated anemia focus on managing anemia, addressing other symptoms of MF, or both.Vachhani P et al. Haematologica. 2026;111(4):1179-1197. Jain AG, Gerds AT. Blood. 2025;145(16):1738-1746. Tefferi A. Am J Hematol. 2023;98(5):801-821. Verstovsek S. Ann Hematol. 2023;102(4):689-698. Myeloproliferative neoplasms (MPNs). Blood Cancer United. Accessed April 2, 2026. https://bloodcancerunited.org/blood-cancer/myeloproliferative-neoplasms-mpns Garmezy B et al. Blood Rev. 2021;45:100691.
Modalities includea
- Janus kinase inhibitors (JAKis)
- Erythroid maturation agents (EMAs)
- Erythropoiesis-stimulating agents (ESAs)
- Semisynthetic androgens
- Immunomodulatory drugs (IMiDs)
- Novel therapies/clinical trials
Transplant
Although potentially curative, each patient’s prognosis is weighed carefully against the potential benefits and risks associated with transplant.Vachhani P et al. Haematologica. 2026;111(4):1179-1197. Tefferi A. Am J Hematol. 2023;98(5):801-821. Verstovsek S. Ann Hematol. 2023;102(4):689-698. Myeloproliferative neoplasms (MPNs). Blood Cancer United. Accessed April 2, 2026. https://bloodcancerunited.org/blood-cancer/myeloproliferative-neoplasms-mpns Garmezy B et al. Blood Rev. 2021;45:100691.
Modalities include
- Allogeneic hematopoietic stem cell transplant
aThere are currently no FDA-approved therapies specifically indicated to treat anemia associated with MF.
Treatment goals in MF-associated anemia
Treatment goals for patients with MF-associated anemia are related to which symptoms need to be addressed and the risk of leukemic progression.Vachhani P et al. Haematologica. 2026;111(4):1179-1197. Myeloproliferative neoplasms (MPNs). Blood Cancer United. Accessed April 2, 2026. https://bloodcancerunited.org/blood-cancer/myeloproliferative-neoplasms-mpns Gangat N et al. J Clin Oncol. 2011;29(4):392-397. Tefferi A et al. Blood. 2024;144(17):1813-1820. Vannucchi AM et al. Ann Oncol. 2015;26(suppl 5):v85-v99.
Figure referencesJain AG, Gerds AT. Blood. 2025;145(16):1738-1746. Tefferi A. Am J Hematol. 2023;98(5):801-821. Passamonti F, Mora B. Blood. 2023;141(16):1954-1970. Verstovsek S. Ann Hematol. 2023;102(4):689-698. Al-Ali HK et al. Cancers (Basel). 2024;16(23):4064. Passamonti F et al. Crit Rev Oncol Hematol. 2022;180:103862 Myeloproliferative neoplasms (MPNs). Blood Cancer United. Accessed April 2, 2026. https://bloodcancerunited.org/blood-cancer/myeloproliferative-neoplasms-mpns Garmezy B et al. Blood Rev. 2021;45:100691. Tefferi A et al. Blood. 2024;144(17):1813-1820. Vannucchi AM et al. Ann Oncol. 2015;26(suppl 5):v85-v99.
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