Watching and waiting may reduce the opportunity to maximize OS1-4
MF is a serious disease that may require active management at diagnosis for the best chance at overall survival2-6
In a study of patients with primary MF, approximately 90% (375/428) of evaluable patients were considered to be intermediate- or high-risk within 1 year of diagnosis7
Any one of the following risk factors† indicates that a patient is already at intermediate risk5,7:
- Hemoglobin <10 g/dL
- Circulating blast cells ≥1%
- Leukocyte count >25 x 109/L
- Platelet count <100 x 109/L
- Age >65 years
- Red cell transfusion dependency
- Constitutional symptoms
- Unfavorable karyotype
†As included in the Dynamic International Prognostic Scoring System Plus tool.
I initiate treatment early to have the best chance of achieving my ultimate goal of overall survival.
Prithviraj Bose, MD, MPN Expert
MF=myelofibrosis; MPN=myeloproliferative neoplasm; OS=overall survival.
References: 1. Bose P. Management of patients with early myelofibrosis: a discussion of best practices. Curr Hematol Malig Rep. 2024;19(3):111-119. 2. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Myeloproliferative Neoplasms V.1.2025. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed May 19, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 3. Tefferi A, Cervantes F, Mesa R, et al. Revised response criteria for myelofibrosis: International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) and European LeukemiaNet (ELN) consensus report. Blood. 2013;122(8):1395-1398. 4. Barbui T, Barosi G, Birgegard G, et al. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. J Clin Oncol. 2011;29(6):761-770. 5. Cervantes F, Dupriez B, Pereira A, et al. New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood. 2009;113(13):2895-2901. 6. Vannucchi AM, Kantarjian HM, Kiladjian J-J, et al. A pooled analysis of overall survival in COMFORT-I and COMFORT-II, 2 randomized phase III trials of ruxolitinib for the treatment of myelofibrosis. Haematologica. 2015;100(9):1139-1145. Supplemental information available at: https://doi.org/10.3324/haematol.2014.119545. 7. Gangat N, Caramazza D, Vaidya R, et al. DIPSS plus: a refined Dynamic International Prognostic Scoring System for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count, and transfusion status. J Clin Oncol. 2011;29(4):392-397.
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