Dr. Jamieson on Treatment Considerations in Myelofibrosis

Catriona Jamieson, MD, PhD, team leader for the Division of Hematology/Oncology at UC San Diego Health Moores Cancer Center, discusses treatment considerations for patients with myelofibrosis.

The treatment for patients with myelofibrosis is now starting earlier in the disease course, according to Jamieson. For example, those with low-risk disease can receive pegylated interferon, which has demonstrated encouraging results and may reduce the level of bone marrow scarring, Jamieson says. Additionally, patients who are symptomatic can be treated with JAK2 inhibitors, such ruxolitinib (Jakafi), or fedratinib (Inrebic) for those with intermediate- to high-risk disease.

Both drugs are available in the first-line setting, and patients can decide between the agents based on their safety profile, although one of the primary adverse effects is financial toxicity, Jamieson notes. In addition to improving quality-of-life, ruxolitinib and fedratinib can modify disease trajectory, and improve overall survival through spleen shrinkage and decreasing inflammatory cytokines, Jamieson concludes.