ANAEMIA-SUPPORTING treatment may enable patients with myelofibrosis to maintain effective ruxolitinib dosing without compromising spleen or symptom responses, according to a new analysis of the phase 3b JUMP trial.
The post hoc analysis evaluated 101 patients with myelofibrosis and baseline haemoglobin below 12.0 g/dL who began an erythropoiesis-stimulating agent (ESA) or danazol within 3 months of enrolment. Researchers found that spleen and symptom responses remained comparable with those seen across the wider JUMP population.
Anaemia is common in myelofibrosis and can also occur as a dose-dependent consequence of treatment with the JAK1/JAK2 inhibitor ruxolitinib.
Researchers therefore investigated whether supportive treatment for anaemia could enable patients to continue receiving adequate doses of ruxolitinib while maintaining clinical benefit.
The analysis included 101 patients with baseline haemoglobin below 12.0 g/dL who initiated either an ESA or danazol within 3 months and continued supportive therapy for at least 3 months. Of these patients, 97% received an ESA.
Outcomes were compared with an unmatched group of 1,242 JUMP participants with haemoglobin below 12.0 g/dL who did not initiate an ESA or danazol during the first 3 months.
Mean total daily ruxolitinib doses remained above 25 mg in patients receiving anaemia-supporting treatment.
At Week 24, 37% achieved a spleen length response, defined as a reduction of at least 50% from baseline. This compared with 28% in the unmatched comparator group.
Symptom response, defined as an improvement of at least 6.5 points on the Functional Assessment of Cancer Therapy-Lymphoma score, was achieved by 26% of patients receiving supportive treatment and 26% of the comparator group. Outcomes were also comparable with those observed across the total JUMP population of 2,233 patients.
Similar findings were reported among the 52 patients whose baseline haemoglobin was below 10.0 g/dL.
Across the groups analysed, haemoglobin initially declined, reaching its lowest point around Week 4 before subsequently increasing.
The findings suggest that managing anaemia with ESAs or danazol may allow patients to maintain ruxolitinib dose intensity while retaining spleen and symptom responses.
However, the researchers noted that the study was a post hoc analysis and the comparator population was unmatched, limiting direct conclusions about the effect of supportive treatment itself.
The authors concluded that the results support anaemia-supporting medications alongside ruxolitinib as a potential strategy for patients with myelofibrosis and anaemia.
Reference:
Vachhani P et al. Outcomes of patients with myelofibrosis treated with ruxolitinib and anemia-supporting medications. Hematology. 2026;31(1):2725339.
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