Combining Anemia Medications With Ruxolitinib in Patients With Myelofibrosis
Key Takeaways:
- A post hoc analysis of the JUMP clinical trial observed the impact of anemia medications on patients with myelofibrosis (MF) receiving ruxolitinib.
- Patients receiving anemia medications maintained optimal ruxolitinib doses and achieved spleen and symptom responses similar to those in the JUMP study.
- These findings indicate that the use of anemia medications with ruxolitinib does not interfere with MF treatment or worsen health outcomes.
Anemia is a common comorbidity among patients with MF, being present in 1 of 3 patients at initial MF diagnosis. The presence of anemia at diagnosis is associated with worse survival outcomes, making disease management crucial to improving health outcomes.
Erythropoietin-stimulating agents (ESAs) and danazol are the typical therapies for anemia in MF, although little research has been done to analyze their impact when used in combination with ruxolitinib.
Study Methods and Outcomes
Researchers conducted a post hoc analysis of the phase 3b JUMP clinical trial to assess health outcomes among patients with MF and anemia who received ruxolitinib along with ESAs or danazol.
Patients with anemia in MF were broken into 2 subgroups based on severity: Hb <12.0 g/dL or Hb <10.0 g/dL.
Outcomes included spleen length response (defined as a reduction greater than 50% from baseline) and symptom response (defined as an increase of 6.5 points or higher in Functional Assessment of Cancer Therapy–Lymphoma [FACT–Lym] score).
Impact of Anemia Medications on MF Treatment
Among the 2233 patients included in the JUMP trial, 1548 (69%) had Hb <12.0 g/dL and 856 patients (38%) had Hb <10.0 g/dL at baseline. Most patients were not receiving treatment for anemia at baseline. After diagnosis, 7.5% patients with Hb <12.0 g/dL and 7.1% with Hb <10.0 g/dL initiated ESA or danazol treatment within 3 months.
Although daily doses of ruxolitinib decreased for both groups, patients still received optimal doses of ruxolitinib (above 25 mg/d).
At week 12, 41.6% of patients in the Hb <12.0 g/dL group and 42.3% in the Hb <10.0 g/dL group achieved spleen length response. Rates remained stable by week 24.
At week 24, 25.7% of patients in the Hb <12.0 g/dL group and 23.1% in the Hb <10.0 g/dL group achieved system response.
Implications for Managed Care
These findings suggest that anemia medications can be used safely in combination with ruxolitinib without compromising its efficacy. Patients receiving ESAs or danazol maintained optimal ruxolitinib doses and achieved spleen and symptom responses comparable to those in the JUMP trial.
The authors said, “Overall, these results suggest that addition of anemia-supporting medication (primarily ESAs) to ruxolitinib in patients with MF provides adequate supportive care for anemia while allowing for long-term maintenance of ruxolitinib dosing and maintaining the improvements in spleen size and symptom burden consistent with ruxolitinib treatment.”
Reference
Vachhani P, Repp J, Hamer-Maansson JE, Braunstein E, Bhatt V, Al-Ali HK. Outcomes of patients with myelofibrosis treated with ruxolitinib and anemia-supporting medications. Hematol. 2026;31(1):2725339. doi:10.1080/16078454.2026.2725339
