How to understand and manage cytopenic myelofibrosis?

During the Texas MPN Workshop (TMW) 2022, the MPN Hub was pleased to speak to Prithviraj Bose, MD Anderson Cancer Center, Houston, US. We asked about understanding and managing cytopenic myelofibrosis (MF).

Bose begins by identifying anemia and thrombocytopenia as the primary cytopenias in MF, posing challenges in the management of patients with MF. Bose notes that there are no drugs approved specifically for the improvement of cytopenias in MF and then discusses two ways to manage cytopenias.

The first approach is using agents that specifically improve cytopenias, such as luspatercept, which is being developed in phase III settings to improve anemia in patients who are on ruxolitinib and still require blood transfusion. The second approach is to use agents with multiple targets, namely cytopenias and disease-related symptoms. Pelabresib, momelotinib, pacritinib, and implications of the clinical trials investigating these agents are discussed. Bose finishes with the optimal dosing of ruxolitinib in patients with cytopenic MF.