2) We welcome new expert faculty member, Dr Stephen Oh @mpndoc, Professor of Medicine and Co-Chief @WashUHematology, whose clinical practice and research interests are focused on #myeloproliferative neoplasms, to lead us through the latest. pic.twitter.com/yqXq3ias70
— @onc_ce (@onc_ce) January 21, 2026
4) So, what do you know? Which of the following are classical features of #myelofibrosis?
— @onc_ce (@onc_ce) January 21, 2026
a) Lymphocytosis
b) Splenomegaly
c) Bulky lymphadenopathy
d) FLT3 mutation
6) Re #luspatercept in #MF-anemia, which is true?
— @onc_ce (@onc_ce) January 21, 2026
a. Met TI prim EP in Ph 3 trial ➡️FDA 👍 for MF‑anemia
b. Missed prim EP but ➡️clinically meaningful ⬆️in hgb & ⬇️transfusions #tx in some pts
c. Worsened anemia & tx needs vs Pbo in most pts
d. Benefit only in JAKi-naïve pts
8) #MF clinical phenotypes, molecular features, and potential treatment options are nicely summarized here:
— @onc_ce (@onc_ce) January 21, 2026
See 🔓https://t.co/mtbjRTHWuQ pic.twitter.com/t8Om8VFKjG
10) But perhaps contributing most significantly to symptomatic, QoL and economic burden of #MF: #anemia is a common manifestation.
— @onc_ce (@onc_ce) January 21, 2026
See 🔓 https://t.co/GwKSerU3qN pic.twitter.com/4PHNJ8Sf9K
12) What are the causes of #anemia in #MF? It’s multifactorial—here’s two views
— @onc_ce (@onc_ce) January 21, 2026
See 🔓https://t.co/9tJRqthFTu pic.twitter.com/V4r5WT6UEV
14a) In #myelofibrosis, #anemia and #thrombocytopenia often co-exist. Patients with both cytopenias experience higher symptom burden, lower quality of life, a greater need for transfusions, & significantly reduced overall survival. See 🔓https://t.co/Ui26m4BMmZ pic.twitter.com/7vEym92JuX
— @onc_ce (@onc_ce) January 21, 2026
15a) Focusing just on management of the #anemia of #MF, what are the options? Let’s start by reviewing @NCCN guidelines for management of MF-associated anemia.
— @onc_ce (@onc_ce) January 21, 2026
See v2.2025 at 🔓 https://t.co/8XW5Efpuoc.
16a) First, there is supportive care–#transfusions, #erythropoiesis-stimulating agents #ESAs, #immunomodulatory agents +/- #steroids, androgens e.g. #danazol. More recently, #JAK inhibitors #JAKi have been used to manage these patients.
— @onc_ce (@onc_ce) January 21, 2026
16c)
— @onc_ce (@onc_ce) January 21, 2026
1⃣ #Ruxolitinib is a JAK1/2 inhibitor approved for intermediate‑ or high‑risk #MF (primary MF, post‑PV MF, post‑ET MF).
2⃣ #Fedratinib is a JAK2‑selective inhibitor approved for intermediate‑2 or high‑risk primary or secondary MF
16e)
— @onc_ce (@onc_ce) January 21, 2026
4⃣ #Momelotinib is a JAK1/2 & ACVR1 inhibitor approved for adults with intermediate‑ or high‑risk MF & anemia; this is the only #JAK inhibitor whose approval explicitly includes MF-anemia in the indication statement.
17b) #Momelotinib is also a safe and effective treatment option for patients with #MF and moderate-to-severe #thrombocytopenia. See 🔓 https://t.co/5XMoBrkpMl pic.twitter.com/ZZ14Wp8IfS
— @onc_ce (@onc_ce) January 21, 2026
17d) #ACVR1 inhibition downregulates SMAD‑mediated #hepcidin production, increasing iron availability and contributing to improvements in hemoglobin and #TI in #MF‑associated anemia. See 🔓https://t.co/2ZAuXlYDT3. pic.twitter.com/6EzAo5aKka
— @onc_ce (@onc_ce) January 21, 2026
18b) Growing evidence links #ACVR1 inhibition to anemia benefit in #MF: #pacritinib shows ~4‑fold greater in vitro ACVR1 potency vs #momelotinib & significantly improves TI rates in cytopenic MF, contrasting w/JAK inhibitors lacking ACVR1 activity that often worsen anemia (ibid)
— @onc_ce (@onc_ce) January 21, 2026
19a) Other #hepcidin-targeting agents in development featured in presentations at #ASH25. #Zilurgisertib (INCB000928), an oral #ALK2/#ACVR1 inhibitor, showed rapid & sustained hepcidin suppression in anemic #MF (poster #3795), confirming on‑target BMP–SMAD pathway engagement. pic.twitter.com/Q545nuAUFZ
— @onc_ce (@onc_ce) January 21, 2026
19c) … and the authors concluded #ALK2 inhibition alone may not be sufficient to correct anemia in MF, due to multifactorial disease biology. Why is #TD vs #TI so important? TD is assoc'd with ⬇️overall survival & significantly ⬇️patients' QoL. 🔓https://t.co/4amhvv5kTg
— @onc_ce (@onc_ce) January 21, 2026
20b) ASH2025 poster #2042 demonstrated these results in the #RALLY_MF Ph 2 trial with a generally acceptable safety profile, reinforcing hepcidin suppression as a promising strategy for MF-associated anemia. #ASH25 #MF #hepcidin
— @onc_ce (@onc_ce) January 21, 2026
21b) This action ⬇️SMAD2/3 signaling & promotes late‑stage #RBC maturation. #Luspatercept is indicated for anemia requiring regular RBC transfusions in adults with beta‑#thalassemia and very low– to intermediate‑risk MDS who are #TD, with or without prior #ESA exposure.
— @onc_ce (@onc_ce) January 21, 2026
22a) So why are we talking about #luspatercept in the context of #MF-anemia? Because despite missing its primary EP in Ph 3 #INDEPENDENCE, it is included in @NCCN guidelines as a cat 2A option for #MF-associated anemia, esp for those with symptomatic splenomegaly on a #JAKi.
— @onc_ce (@onc_ce) January 21, 2026
23a) Two key #ASH2025 datasets expanded the MF‑anemia story for #luspatercept beyond INDEPENDENCE, focusing on early-phase efficacy/biomarkers and broader real‑world/longitudinal experience.
— @onc_ce (@onc_ce) January 21, 2026
23c) #ASH2025 Abstract 2825: real-world experience with #luspatercept in MF‑anemia ➡️sustained ⬆️ in hgb & and meaningful ⬇️in transfusion burden, w/safety consistent w/prior indications, suggesting that luspatercept can offer durable #anemia benefit for select #MF patients. pic.twitter.com/C3M5f0xi7g
— @onc_ce (@onc_ce) January 21, 2026
24b) Beyond anemia, elritercept + ruxolitinib was assoc'd w/broader benefit at the #RP2D in #MF, inc ⬆️platelet counts & ⬇️ symptom burden, w/ a manageable safety profile, reinforcing #activin/TGF‑β ligand trapping as a promising strategy for multi‑lineage #cytopenias in MF.
— @onc_ce (@onc_ce) January 21, 2026
25) And now you are UP TO DATE! Claim your 0.75hr 🆓CE/#CME at https://t.co/wa61qDo9H5 and FOLLOW US for more expert-authored #tweetorials right here on @onc_ce! Many thanks to @mpndoc this program! pic.twitter.com/LdH4aDdeKe
— @onc_ce (@onc_ce) January 21, 2026