Dr. Michaelis on Treating Patients With Myelofibrosis and Anemia

Laura C. Michaelis, MD, associate professor of medicine, Division of Hematology and Oncology, Medical College of Wisconsin, discusses the treatment of patients with myelofibrosis and anemia.

It is common for patients with myelofibrosis to present with anemia, says Michaelis. Notably, treatment with ruxolitinib (Jakafi) may exacerbate anemia in this patient population.

Combining ruxolitinib with an erythropoiesis-stimulating agent like darbepoetin alfa (Aranesp), or an androgen agent like danazol (Danocrine) may mitigate anemia in some patients.

Additionally, some patients with myelofibrosis and anemia have extramedullary hematopoiesis resulting from an enlarged spleen. Patients receiving ruxolitinib may see a rise in their hemoglobin as their spleen shrinks despite the drug’s myelosuppressive effect, concludes Michaelis.