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A 76-Year-Old Woman with Newly Diagnosed MF

Case Based Peer Perspectives

Advice for Clinicians Treating Patients With MF

Videos

Anthony Hunter, MD, presents the case of a 76-year-old woman with newly diagnosed myelofibrosis for discussion and reviews the available treatment options, including the recently FDA approved JAK inhibitor momelotinib.

Anthony Hunter, MD, presents the case of a 76-year-old woman with newly diagnosed primary myelofibrosis with a JAK2 mutation, for which he recommended treatment with momelotinib due to her moderate anemia and refusal of transplant.

Case Presentation: A 76-Year-Old Woman With Newly-Diagnosed Myelofibrosis (MF)

Defining Myelofibrosis

Myelofibrosis can be categorized as primary (developing de novo) or secondary (arising in patients with pre-existing MPNs), and it further distinguishes between proliferative and cytopenic types, with each type having its unique diagnostic criteria and implications for treatment.

Types of Myelofibrosis

Anthony Hunter, MD, details the primary goals when treating a typical patient with myelofibrosis, such as improving symptoms like weight loss and fatigue, addressing anemia, and, more recently, striving to extend survival, with treatments like JAK inhibitors showing potential for improving overall survival in patients.

Treatment Goals for Patients With MF

Dr Anthony Hunter explains that the decision to initiate therapy in patients with myelofibrosis is individualized, considering factors like symptoms and risk stratification; early treatment with JAK inhibitors is crucial for symptom control, but allogeneic stem cell transplant remains the only potential curative therapy, particularly for higher-risk patients.

When to Initiate Therapy in Patients With MF

Momelotinib, a recently approved treatment for myelofibrosis, targets multiple pathways,and offers a promising approach to improve anemia, especially in patients who did not respond optimally to previous JAK inhibitors.

Rationale for Treatment With Momelotinib in Patients With MF

Anthony Hunter, MD, explains that anemia is a common complication in patients with myelofibrosis, often worsening over time; treatment strategies involve monitoring, transfusion support, and considering additional anemia-directed agents.

Managing Anemia in Patients With MF Receiving Momelotinib

The SIMPLIFY-1 trial investigated the use of momelotinib in JAK inhibitor-naive patients with myelofibrosis, primarily symptomatic with spleen enlargement, hepatomegaly, or anemia; results showed momelotinib led to improved transfusion independence, reduced transfusion burden, and decreased anemia compared to ruxolitinib.

Momelotinib in MF: Data from the SIMPLIFY-1 Trial

Dr Anthony Hunter reviews the other three approved JAK inhibitors for treatment of myelofibrosis: ruxolitinib, fedratinib, and pacritinib.

Other Therapies Approved for Patients With MF

Anthony Hunter, MD, closes his discussion by sharing advice for clinicians treating patients with myelofibrosis.

Advice for Clinicians Treating Patients With MF

EP: 1.Case Presentation: A 76-Year-Old Woman With Newly-Diagnosed Myelofibrosis (MF)

EP: 2.Defining Myelofibrosis

EP: 3.Types of Myelofibrosis

EP: 4.Treatment Goals for Patients With MF

EP: 5.When to Initiate Therapy in Patients With MF

EP: 6.Rationale for Treatment With Momelotinib in Patients With MF

EP: 7.Managing Anemia in Patients With MF Receiving Momelotinib

EP: 8.Momelotinib in MF: Data from the SIMPLIFY-1 Trial

EP: 9.Other Therapies Approved for Patients With MF

EP: 10.Advice for Clinicians Treating Patients With MF