Recommendations for managing MF with a focus on patients with cytopenias from the global consensus group

A comprehensive assessment, including accurate diagnosis and appropriate treatment, is crucial in optimizing the management of MF-related anemia. All available and emerging therapeutic options should be considered for MF- and treatment-related anemia; only momelotinib is specifically approved for MF-related anemia.  

The recommendations from the German Society of Hematology and Medical Oncology and the Society of Thrombosis and Hemostasis Research can serve as a basis for treatment decisions for MF and thrombocytopenia.  

Momelotinib and pacritinib are the only JAKis approved for use in patients with MF and severe thrombocytopenia (platelet count, ≥25 x 10⁹/L and <50 x 10⁹/L, respectively). In addition to JAKi monotherapy, RUX-based combination therapies are effective in managing MF-related anemia. 

Physicians should not be restricted by definitions of R/R and suboptimal response but instead use them to inform the timing of potential treatment switches. The expert group recommended that collaborative efforts should focus on refinement of the RUX failure criteria to distinguish resistance from intolerance, and these definitions should be extended to other JAKis. 

Validated prognostic tools and clinical variables should be used to predict survival benefits and to guide clinical decisions in the management of MF. 

The panel suggested advocating better trial endpoints to increase their relevance and applicability in real-world clinical settings, while highlighting the need for broader inclusion criteria in clinical trials.