EHA 2026 | Challenges that remain when managing patients with myelofibrosis

With myelofibrosis, we still have great, great achievements with the introduction of the JAK inhibitors. The first being Ruxolitinib, next Pacritinib and also Momelotinib. But still, there is a lot of unmet needs. The first goal physicians have when they treat patients is to make patients’ quality of life become better. This spleens, if there is some dramatic enlargement, which is quite often in these patients, to improve that too. But then the next challenge is to improve survival. And always the balance, you know, between efficacy and safety becomes a very big issue. I need to have, or ideally I want to give an effective treatment with an effective dose to achieve the long-term and the short-term goals. But based particularly for Ruxolitinib, which is a standard of care in the treatment of many patients with myelofibrosis, we know the issue of anemia often arises, partly because of the disease itself, where half of the patients are already anemic and around 20% become transfusion dependent in the course of the disease. And this produces the challenge of how to balance between the anemia, transfusion dependency on one side and an effective treatment. With the introduction of Momelotinib for anemia transfusion-dependent patients, it seems to be easier, particularly for patients with anemia, for those that are transfusion dependent. But still, this balance between efficacy and safety, and particularly anemia, for those that are transfusion dependent, but still this balance between efficacy and safety and particularly anemia, MF-related versus treatment-related, remains a challenge for an optimal management of patients with a chronic disease.

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