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5 treatment settings, 5 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Observation; aspirin for thrombosis risk where platelets are high; hydroxyurea or interferon for proliferative features.
Aspirin is not a cancer drug but sits in cancer care in two places: low doses prevent clots in polycythaemia vera and essential thrombocythaemia, and long-term use lowers colorectal cancer in people with Lynch syndrome, while a trial in the healthy elderly found no benefit and possible harm.
Hydroxyurea is a cheap, decades-old pill that lowers high blood counts in polycythaemia vera and essential thrombocythaemia and is also the main drug for sickle cell disease.
Ropeginterferon alfa-2b is a long-acting interferon for polycythaemia vera that, unlike hydroxyurea, can shrink the mutant clone over years.
Peginterferon alfa-2b, a long-acting interferon, was approved in 2011 as Sylatron for melanoma that had spread to lymph nodes and been removed, to delay recurrence; checkpoint inhibitors have since replaced it in that role.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.
Add these to your appointment list, or take the full question set for this cancer.
Ruxolitinib (COMFORT-I and II) first; fedratinib after ruxolitinib failure or intolerance; pacritinib if platelets are below 50 x 10^9/L; momelotinib if anaemic.
Ruxolitinib was the first JAK inhibitor: it shrinks the spleen and relieves symptoms in myelofibrosis and controls blood counts in polycythaemia vera, without eliminating the disease clone.
A second JAK inhibitor for myelofibrosis that works after ruxolitinib fails; it carries a boxed warning for a rare brain toxicity (Wernicke encephalopathy) so thiamine is checked.
The JAK inhibitor for myelofibrosis patients whose platelet counts are too low for ruxolitinib.
Momelotinib is the JAK inhibitor designed for anaemic myelofibrosis patients: it can improve haemoglobin while shrinking the spleen.
Spleen volume reduction of 35 percent or more at 24 weeks in 41.9 percent of patients on ruxolitinib against 0.7 percent on placebo; approved in the United States in November 2011.
Spleen volume reduction of at least 35 percent at week 48 in 28 percent of patients on ruxolitinib against 0 percent on best available therapy; European approval in 2012.
Add these to your appointment list, or take the full question set for this cancer.
Momelotinib (MOMENTUM), erythropoiesis-stimulating agents where erythropoietin is low, danazol, transfusion with iron chelation; luspatercept in trials (INDEPENDENCE).
Momelotinib is the JAK inhibitor designed for anaemic myelofibrosis patients: it can improve haemoglobin while shrinking the spleen.
Epoetin alfa is a manufactured version of the kidney hormone that tells the bone marrow to make red blood cells. In cancer it treats anaemia caused by chemotherapy and reduces the need for transfusions, but it is used cautiously because it can shorten survival and cause clots.
Red cell and platelet transfusions, iron and erythropoiesis-stimulating agents keep patients safe through chemotherapy and marrow failure; restrictive thresholds and ESA caution reflect trials showing more is not better.
An injection that helps the marrow finish making red cells, reducing or removing the need for transfusions in lower-risk MDS and beta-thalassaemia.
No headline result recorded yet.
No headline result recorded yet.
Add these to your appointment list, or take the full question set for this cancer.
Allogeneic stem cell transplant, usually under 70 and at MIPSS70 high or DIPSS intermediate-2 or higher, after JAK inhibitor to reduce spleen size.
Allogeneic stem cell transplantation replaces a patient's blood system with a donor's after conditioning chemotherapy, so donor immune cells hunt down leukaemia left behind. It remains the only cure for adverse-risk acute myeloid leukaemia, high-risk acute lymphoblastic leukaemia and Richter transformation, at the price of graft-versus-host disease.
Ruxolitinib was the first JAK inhibitor: it shrinks the spleen and relieves symptoms in myelofibrosis and controls blood counts in polycythaemia vera, without eliminating the disease clone.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
Add these to your appointment list, or take the full question set for this cancer.
Switch JAK inhibitor; combination trials of ruxolitinib with navitoclax, pelabresib, selinexor or imetelstat; imetelstat versus best available therapy in IMpactMF.
Navitoclax is an experimental small-molecule drug from AbbVie in phase 3 trials for myeloproliferative neoplasms, with its target not yet stated publicly.
Pelabresib is an experimental small-molecule drug from Novartis Pharmaceuticals in phase 3 trials, with its target not yet stated publicly.
Selinexor is a first-in-class pill that traps tumour-suppressor proteins inside the nucleus; approved in myeloma, it failed its endometrial cancer test in 2026.
Imetelstat is a lipid-linked oligonucleotide that binds the RNA template of telomerase, the enzyme cancer cells use to stay immortal, and it is the first telomerase inhibitor approved for any cancer. In lower-risk myelodysplastic syndromes it freed 40% of transfusion-dependent patients from transfusions for at least eight weeks versus 15% on placebo, once growth factors have failed.
No headline result recorded yet.
No headline result recorded yet.
No headline result recorded yet.
No headline result recorded yet.
Add these to your appointment list, or take the full question set for this cancer.