ASH 2025 | Therapeutic options available in the UK for patients with myelofibrosis

I would refer you to the recently published BSH guideline, which takes you through all these options. The patient should be assessed and probably scored with one of the grading systems. And then for medical treatment, if they come to a sufficiently advanced myelofibrosis where they need treatment, we have currently available first-line ruxolitinib. Momelotinib is also available in those who are anemic, and we can get into a debate as to how you define anemia, but you’re usually thinking of a hemoglobin less than 100. Fedratinib in the UK is licensed second line, so in those with ruxolitinib failure, and those are the medical options currently. Obviously, clinical trials come in and need to be considered either first line or later on when they aren’t responding to treatment. 

And of course, the only curative treatment for myelofibrosis is an allogeneic bone marrow transplant. That’s a difficult decision. It should be considered right at the beginning: is this a patient for transplant, and again, a decision with the patient and the physicians, and obviously, age, comorbidities, things come into that, and then it can be difficult further on because and at what point do you decide to go to transplant? But that has to be all part of the equation.

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