Dr. Mauro on Considerations for Early Treatment Initiation in Myelofibrosis

Michael J. Mauro, MD, the leader of the Myeloproliferative Neoplasms Program at Memorial Sloan Kettering Cancer Center, discusses considerations for early treatment initiation in myelofibrosis.

Disease progression occurs on a spectrum in myelofibrosis, ranging from asymptomatic disease to radiographic disease progression or pathologic disease progression, Mauro explains. However, progression is most often driven by symptom burden, Mauro adds.

Ruxolitinib (Jakafi), the mainstay of treatment in myelofibrosis, is associated with symptom management and quality of life (QOL) improvement, Mauro says. However, patients without significant symptom burden, which would be indicative of treatment initiation, could still be treated early, Mauro explains. Early utilization of chronic maintenance treatment can reduce splenomegaly and improve blood counts, as well as potentially alter the natural biology of the disease, Mauro says. As such, patients who have some critical mass of symptoms in which treatment is warranted should be treated early, Mauro concludes.