Momelotinib for myelofibrosis with anaemia: Spanish real-world data

Dr Lucia Pérez-Lamas, a haematologist at Hospital Universitario Puerta de Hierro, Madrid, Spain, presented real-world data on momelotinib for myelofibrosis patients with anaemia, collected from 54 patients across 74 centres.

The median patient age at treatment initiation was 72 years, with most patients at high or intermediate-2 risk. Median haemoglobin levels were 8.0 g/dL, and 70% were transfusion-dependent at baseline. Of these, 23% were JAK inhibitor-naïve, while 77% had prior exposure to JAK inhibitors. Symptom improvement was observed in 92% of symptomatic patients. Haemoglobin increased to 9.3 g/dL within three months, stabilising by six months. Transfusion independence was achieved in 48% of patients by three months and sustained through 12 months. JAK-exposed patients demonstrated greater anaemia response than JAK-naïve patients. For those remaining transfusion-dependent, median red blood cell transfusions decreased from four to 2.25 units per month.

Splenomegaly improved in 60% of patients, with 25% meeting the 2013 ELN-EWG criteria. JAK-naïve patients showed slightly better spleen responses and greater median reductions in spleen size.

Frequent adverse events included diarrhoea, thrombocytopenia, nausea, hepatotoxicityand dizziness. Grade 3–4 adverse events included thrombocytopenia (6%), hepatotoxicity (2.5%) and infections (3%). After a median follow-up of 5.5 months, 79% remained on momelotinib. Discontinuations occurred due to toxicity (6 patients), lack of efficacy (5 patients), disease progression, AML transformation or death.