Anemia Management in Myelofibrosis: Survival and Quality of Life

Dr. Francesca Palandri, associate professor of Hematology at the University of Bologna in Italy and a physician at the IRCCS Azienda Ospedaliero-Universitaria di Bologna (also known as Sant'Orsola-Malpighi Hospital), recently spoke with us about the role of anemia management in myelofibrosis.

As a study author of the phase 3 SIMPLIFY-1 trial, Palandri gave insight into understanding how anemia affects patient outcomes. Patients with myelofibrosis frequently experience significant anemia, which influences survival, as well as substantially impacts quality of life and daily functioning. In this interview with CURE, she discussed why improving hemoglobin levels is essential, how transfusion dependency affects patients, and the broader economic and organizational implications.

Palandri also explored the potential of therapies such as Ojjaara (momelotinib) to address anemia while simultaneously controlling disease-related symptoms, highlighting its promise in improving both patient quality of life and overall survival.

CURE: Can you explain why improving anemia is important for overall survival and quality of life?

Palandri: Unfortunately, anemia is one of the main features of myelofibrosis. We know that around 40% of patients will present with hemoglobin less than 10 grams per deciliter at diagnosis, and that percentage increases to around 60% after one year. We also know that about one-quarter of patients require transfusions at diagnosis, and that number nearly doubles within the first year.

Any degree of anemia correlates with decreased survival — patients with severe anemia have a median survival that’s four times shorter than those with no anemia at all. That’s why low hemoglobin is a key factor included in all current prognostic scoring systems for myelofibrosis.

But anemia isn’t only about survival or the risk of transformation to leukemia. It also significantly impacts quality of life. Many patients find transfusions to be very burdensome. Transfusion dependency correlates with a worse quality of life and a greater symptom burden, especially fatigue, which is linked to reduced productivity and social engagement.

What are some of the broader impacts of anemia for patients, caregivers and the healthcare system?

Well, in Italy, for example, we recently evaluated both the economic and organizational burden of anemia in myelofibrosis. We found that patients who require transfusions spend six times more time in hospitals than patients without anemia. There were also 40 times higher direct healthcare costs for the National Health System. We looked at indirect costs too — including lost productivity for both patients and caregivers — and found they were six times higher in transfusion-dependent patients.

We also asked patients about their perception of anemia, and they reported a significant disruption across all aspects of their lives, including social, work and daily activities. So overall, anemia is a major burden — for the healthcare system, for caregivers and most importantly, for patients. It’s also a strong indicator of poor prognosis.

Can you explain what patients should understand about the potential survival impact of Ojjaara, particularly in relation to its anemia-targeting events?

Well, I think Ojjaara is the first and only JAK1/JAK2 inhibitor that can simultaneously address the three main hallmarks of myelofibrosis: control of splenomegaly, control of symptoms and improvement of anemia. Once we can target all three of these features together, this can result in an improvement in overall survival. We are accumulating more and more evidence that directly correlates resolution of anemia and achievement of transfusion independence with longer overall survival. I think this is going to become one of our major therapeutic targets in the future.

References

1. Ojjaara May Improve Anemia and Reduce Transfusions in Myelofibrosis, by Dr. Francesca Palandri. CURE; July 18, 2025. https://www.curetoday.com/view/ojjaara-may-improve-anemia-and-reduce-transfusions-in-myelofibrosis
2. Ojjaara Treats Myelofibrosis Symptoms, Anemia and Enlarged Spleen, by Dr. Francesca Palandri. CURE; July 24, 2025. https://www.curetoday.com/view/ojjaara-treats-myelofibrosis-symptoms-anemia-and-enlarged-spleen

Transcript has been edited for clarity and conciseness.

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