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January 2024 | NP-BE-MML-WCNT-230001

CYTOPENIAS

CONSTITUTIONAL SYMPTOMS

SPLENOMEGALY

Anaemia icon

CYTOPENIAS

  • Progressive bone marrow fibrosis can lead to worsening cytopenias, including anaemia, thrombocytopenia and neutropenia2,6
    • Anaemia in MF may result from disruption in normal erythropoiesis due to a proinflammatory environment, fibrotic bone marrow, increased red blood cell (RBC) turnover and splenic sequestration3
      • As MF progresses, anaemia can become more prominent, either through a direct consequence of disease progression or due to therapies used to treat the disease. RBC transfusions remain critical in managing the anaemia aspect of MF3
      • Anaemia and transfusion dependence are key adverse prognostic factors and are associated with increased complications and poor overall survival3

At diagnosis

44% icon

of MF patients*
are anaemic7

33% icon

of MF patients* present with haemoglobin <10 g/dL7


    • Thrombocytopenia in MF can result from multiple causes, including ineffective haematopoiesis, splenic sequestration, and treatment-related effects8
      • Thrombocytopenia occurs when there is a deficiency of platelets in the blood, in adults defined as <150 x 109 platelets/L9
      • 18% of MF patients present with platelet counts <150 x 109/L at diagnosis, with thrombocytopenia becoming more common with disease progression7
      • Thrombocytopenia is an adverse prognostic factor and closely linked to disease progression4
    •  Neutropenia, or a low white blood cell count, weakens the immune system, making it harder for the body to fight infection10
      • Numerous factors may cause neutropenia through destruction, decreased production, or abnormal storage of neutrophils11
Constitutional symptoms icon circle with no title

CONSTITUTIONAL SYMPTOMS

  • The abnormal production of cytokines is thought to result in constitutional symptoms (fever, night sweats, itchy skin, weight loss, etc) in MF2
  • Constitutional symptoms are some of the most common presenting symptoms in MF and can severely compromise the quality of life in patients2
  • 30% of patients with MF present with constitutional symptoms at diagnosis7
  • The presence of constitutional symptoms is an adverse prognostic factor when estimating the survival of patients with MF2,12
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Symptoms may include night sweats, pruritus, undesired weight loss, and fever2

At diagnosis

27% icon

27% of MF patients experience unexplained tiredness7

21% icon

21% of MF patients experience unintended weight loss7

16% icon

16% of MF patients experience abnormal sweats7

Splenomegaly icon circle

SPLENOMEGALY

  • Patients with MF often suffer from splenomegaly, or an enlarged spleen, due to splenic extramedullary haemtopoiesis (EMH)13
  • The symptoms of splenomegaly are associated with spleen size13
  • Progressive splenomegaly is significantly associated with debilitating symptoms including early satiety, dysregulated gastrointestinal function, portal hypertension, decreased physical activity, deteriorative abdominal pain, the progression of cytopenia due to splenic sequestration in MF, and some patients may also experience splenic infarcts5
  • Splenomegaly-related symptoms can contribute to the morbidity associated with MF5
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Symptoms may include left upper abdominal pain and severe abdominal discomfort2

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About half of MF patients
present with an enlarged spleen at diagnosis7

Based on REALISM UK, a multi-center, retrospective, non-interventional study of real-world data of 200 patients in the United Kingdom7

EMH, extramedullary haematopoiesis; MF, myelofibrosis; RBC, red blood cell

References: 1. Verstovsek S et al. Ann Hematol. 2020;99(11):2555-2564. 2. Mughal TI et al. Int J Gen Med. 2014;7:89-101. 3. Naymagon L, Mascarenhas J. HemaSphere. 2017;1(1):e1. 4. Scotch AH et al. Leuk Res. 2017;63:34-40. 5. Randhawa J et al. J Hematol Oncol. 2012;5:43. 6. Bose P, Verstovsek S. Curr Hematol Malig Rep. 2018;13(3):164-172. 7. Mead AJ et al. Ther Adv Hematol. 2022;13:1-15. 8. Sastow D et al. Clin Lymphoma Myeloma Leuk. 2022;22(7):e507-e520. 9. Sekhon SS, Roy V. South Med J. 2006;99(5):491-498. 10. Infection risk and neutropenia. Blood Cancer UK. Accessed March 15, 2023. Available at: https://bloodcancer.org.uk/understanding-blood-cancer/blood-cancer-side-effects/neutropenia/neutropenia/ 11. Neutropenia: causes. Mayo Clinic. Published November 24, 2022. Accessed March 15, 2023. https://www.mayoclinic.org/symptoms/neutropenia/basics/causes/sym-20050854 12. Mesa RA et al. Leuk Res. 2009;33(9):1199-1203. 13. Song MK et al. Int J Mol Sci. 2018;19(3):898.