Dr Gerds on the Development of Anemia in Low-Risk Myelofibrosis

“The form of progression that was most common for these patients was the development of anemia, which is not too surprising. If we look at all patients with myelofibrosis, roughly 30% to 40% of patients will have anemia at the time of diagnosis, and upwards of 40% to 60% of patients over the first year after the diagnosis will develop anemia.”

Aaron Gerds, MD, an assistant professor of Medicine (Hematology and Medical Oncology) at the Cleveland Clinic Taussig Cancer Institute, discussed the development of anemia as the most common form of progression in patients with low- to intermediate-1–risk myelofibrosis.

In the prospective, observational MOST trial (NCT02953704), the most common form of myelofibrosis progression was anemia, which was not a surprising finding, Gerds began. He noted that among all patients with myelofibrosis, approximately 30% to 40% of patients will develop anemia at diagnosis, with 40% to 60% developing anemia within the first year following diagnosis.

The study evaluated patients in 2 cohorts, which included those with low-risk or intermediate-1–risk disease who were considered to have intermediate-1–risk based on age (cohort A; n = 205) and those with intermediate-1–risk based on Dynamic International Prognostic Scoring System (DIPSS) risk factors beyond age (cohort B; n = 27). Data from the study revealed that 58.5% of patients enrolled in cohort A met at least 1 criterion for disease progression following a median follow-up of less than 53 months—a rate that was higher than investigators expected, Gerds explained. Specifically, in cohort A, the most common progression criteria met included a hemoglobin level of less than 10 g/dL (47.5%) and a platelet count of less than 100 x 109/L (31.7%).

Of note, progression rates increased over the course of the study; in cohort A, the median time to first and second disease progression was 24.9 months and 28.2 months, respectively. However, the median time to third progression was 11.6 months.