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During an MPN Hub symposium presented at the European School of Haematology (ESH) 4th How to Diagnose and Treat: CML/MPN conference, MPN Hub steering committee Chair Jean-Jacques Kiladjian, Université Paris Cité and Hôpital Saint-Louis, Paris, FR, presented a review of anemia in myelofibrosis (MF), with a focus on the impact of anemia on patient outcomes.
Key points
- MF is associated with a range of clinical manifestations and constitutional symptoms, including anemia, that significantly impact patient outcomes.
- The cause of anemia in MF is multifactorial, including splenomegaly-induced hemodilution and increases in plasma volume, red blood cell sequestration and destruction, and ineffective erythropoiesis; it can also be caused or exacerbated by certain MF treatments.
- Anemia is prevalent in patients with MF, with ~40% of patients anemic at diagnosis and ~25% of patients transfusion dependent at diagnosis, rising to almost 60% and 50% respectively within the first year of diagnosis and increasing further over time. It is often severe (defined as <8g/dL hemoglobin or transfusion dependence).
- Anemia is included in all MF prognostic scoring systems, and both anemia severity and transfusion dependence are strongly predictive of reduced QoL and survival outcomes in patients with anemia.
- Anemia and increasing severity of anemia significantly reduce OS for patients with MF.
- The median OS in transfusion-independent patients is ~62 months, and only ~22 months in highly transfusion-dependent patients.
- Transfusion burden can impact employment and social life.
- Improving anemia is an important goal alongside targeting spleen size and symptoms for improving everyday QoL and long-term outcomes in patients with MF.
- Anemia therefore represents an important consideration for treatment decision-making.
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