How is red blood cell (RBC) transfusion used to manage anemia in myelofibrosis (MF) patients?

FAQ published on January 13, 2022
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Srdan Verstovsek, MD, PhD
United Energy Resources, Inc.
Professor of Medicine
University of Texas
MD Anderson Cancer Center
Houston, Texas
How is red blood cell (RBC) transfusion used to manage anemia in myelofibrosis (MF) patients?

Anemia is a common occurrence in MF patients. An analysis of MF patients presenting to the Mayo Clinic revealed that nearly 40% of these individuals have significant anemia, defined as hemoglobin (Hb) <10 g/dL.1 Almost one-fourth of MF patients initiate RBC transfusion at diagnosis, typically on a biweekly schedule.2 These individuals are referred to as ‘transfusion dependent.’ Rates of anemia typically increase over time. At one year post-diagnosis, two-thirds of MF patients are anemic and 45% are transfusion dependent, attesting to the progressive nature of this disease.2,3

The threshold for transfusion is typically about Hb <8 g/dL. However, the era of COVID-19 has seen a reduction in the blood supply and a reluctance to unnecessarily expose patients to potential infection, so many experts have decreased the threshold to <7 g/dL. Interestingly, this new threshold may be adopted into standard practice, as studies show that patients can maintain a good quality of life with lower Hb levels than previously assumed.4

For more information on the treatment of MF-associated anemia, please view the full newsletter by clicking here.

This activity is supported by educational grants from Bristol-Myers Squibb and Incyte Corporation.

References:

  1. Tefferi A, Lasho TL, Jimma T, et al. One thousand patients with primary myelofibrosis: The Mayo Clinic experience. Mayo Clin Proc. 2012;87:25-33.
  2. Naymagon L, Mascarenhas J. Myelofibrosis-Related Anemia: Current and Emerging Therapeutic Strategies. Hemasphere. 2017;20(1):e1.
  3. Seymour C. Week 24 Transfusion Independence With Momelotinib Is Associated With Improved OS in Myelofibrosis. June 10, 2021. https://www.onclive.com/view/week-24-transfusion-independence-with-momelotinib-is-associated-with-improved-os-in-myelofibrosis. Accessed January 4, 2022.
  4. Koutsavlis I. Transfusion Thresholds, Quality of Life, and Current Approaches in Myelodysplastic Syndromes. Anemia. 2016;2016:8494738.
Last modified: January 13, 2022