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Current and future therapies for myelofibrosis
Samir Asher1, Donal P McLornan1, Claire N Harrison1
1Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK.
Blood Reviews
|June 16, 2020
Summary
Myelofibrosis, a challenging myeloproliferative disorder, requires advanced prognostication and therapies. While allogeneic stem cell transplant offers a cure, novel JAK and non-JAK inhibitor treatments are emerging for broader patient access.
Area of Science:
- Hematology
- Oncology
- Internal Medicine
Background:
- Myelofibrosis is a Philadelphia-chromosome negative clonal myeloproliferative disorder.
- Its heterogeneity and complex clinical manifestations present therapeutic challenges.
- Curative treatment is primarily limited to allogeneic stem cell transplant for select patients.
Purpose of the Study:
- To discuss updated prognostication methods for myelofibrosis.
- To review common clinical challenges and therapeutic strategies.
- To explore novel therapies, including JAK inhibitors and non-JAK inhibitors.
Main Methods:
- Utilizing patient-specific, hematological, and genomic parameters for prognostic modeling.
- Focusing on difficult clinical scenarios like anemia, thrombocytopenia, and extremes of age.
- Discussing standard and novel therapeutic approaches, including switching JAK inhibitors.
Main Results:
- Prognostic modeling is becoming increasingly complex and accurate.
- Management of anemia, thrombocytopenia, and elderly patients remains challenging.
- Novel JAK and non-JAK inhibitor therapies are under development.
Conclusions:
- Accurate prognostication is crucial for guiding myelofibrosis treatment decisions.
- Addressing clinical challenges and exploring novel therapies are essential for improving patient outcomes.
- Future therapies aim to expand treatment options beyond stem cell transplantation.
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