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Adverse Management and Supportive Care in Myelofibrosis Treatment

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This activity is available for 0.25 CME/CE credit(s).

Released: August 18, 2026

Expiration: February 17, 2027

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1 Pre Assessment 2 Text Module 3 Post Assessment 4 Evaluation 5 Credit

Selecting and sequencing JAK inhibitors in myelofibrosis requires balancing disease risk, symptom and spleen burden, cytopenias, prior treatment response, comorbidities, and patient preferences. In this text module, expert faculty examines evidence-based approaches to first- and later-line therapy, recognition of ruxolitinib resistance or intolerance, and transition strategies when treatment response is inadequate or adverse events limit therapy. Learners will also review practical monitoring, supportive care, and adverse event management considerations for ruxolitinib, fedratinib, pacritinib, and momelotinib to help individualize treatment, maintain clinical benefit, and reduce avoidable gaps in care.

Sara Leidy
Sara Leidy, PharmD, BCOP
AE Management in MF

Pre Assessment

Assess your current knowledge and clinical approach before beginning your text module.
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1.

How many people with MF do you provide care for in a typical month?​

2.

For those who practice in academic or community settings, please indicate your practice setting:

3.

  • SN is a 72-year-old woman with a new diagnosis of higher-risk MF. In addition to significant symptoms, she presents with the following initial laboratory values:​

  • Hgb 9.8 g/dL; platelets 105 x 109/L; white blood cell count 6.4 x 109/L​

  • She is started on ruxolitinib 10 mg PO BID​

  • SN returns to clinic in 1 month and reports a new rash, which is identified as herpes zoster; ruxolitinib is held at this time​

  • Given her robust response to ruxolitinib, therapy is restarted at 5 mg PO BID after a course of antiviral medication and resolution of herpes zoster​

  • SN returns to clinic and is found to have recurrent herpes zoster and worsening anemia now requiring transfusions​

In the setting of recurrent herpes zoster and anemia requiring transfusions, but otherwise stable labs, what would be the next step for SN?​

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