ASH 2024 | Examining the outcomes of patients with myelofibrosis and new/worsening anemia treated with rux

One of the big questions we have in treating myelofibrosis is what do we do with anemia that occurs while on treatment? So we know that anemia is quite common with the disease myelofibrosis. Most patients will experience some degree of anemia throughout the course of their disease, but also we know that our standard approaches, ruxolitinib being kind of the primary JAK inhibitor we use in the frontline setting for myelofibrosis patients often causes its own degree of anemia, which can be quite challenging. And so we have data, lots of data, right, that show that anemia that develops during ruxolitinib therapy does not impair responses to ruxolitinib in terms of spleen and symptoms. But we also have data that suggests that anemia that occurs during ruxolitinib therapy or that just is part of the disease is quite a strong prognostic factor and predicts for overall poor outcomes in terms of survival. And so the question really is, you know, how can we leverage large data sets now that we have these huge data sets that we can sometimes mine to give us a better understanding of how anemia that develops, new anemia that develops during ruxolitinib therapy may impact overall survival. 

And I think not surprising, we saw that anemia that develops that is new or worsening during therapy does convey a worse overall outcome compared to those patients that don’t develop this new anemia. And so, I think that is in line with prior data. Certainly, I think there is some nuance there of kind of teasing out disease-related versus treatment-related anemia, but there probably is components of both, right, within that feature or within many of these patients. And so now the question is, how do we use that information in the current era where we have four different approved JAK inhibitors, right? Some that are a bit more favorable in terms of their impact on anemia and thrombocytopenia. And so I really think this was an effort that we undertook looking at real-world data to try to un-muddy the waters and really clarify the impact of anemia that develops during treatment. Hopefully, we can utilize this when making better treatment decisions for patients in the future.

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