Program Description
Myelofibrosis is a progressive myeloproliferative neoplasm characterized by bone marrow fibrosis, cytopenias, splenomegaly, debilitating constitutional symptoms, and risk of leukemic transformation. JAK inhibitors (JAKis) have become the cornerstone of myelofibrosis therapy, yet optimizing their use required oncology pharmacists to understand each agent's distinct efficacy and safety profile. Though ruxolitinib remains the foundational therapy, fedratinib, pacritinib, and momelotinib have expanded treatment options for patients with specific challenges such as severe thrombocytopenia or MF-associated anemia. Despite these advances, oncology pharmacists face complex clinical decisions surrounding patient-specific JAKi selection, evidence-based dosing and titration strategies, and the proactive management of JAKi-induced cytopenias as well as nonhematologic toxicities. The discussion will encompass approaches to navigate treatment sequencing when patients experience suboptimal responses or intolerable toxicity, with attention to safe transition strategies including tapering, overlap periods, and dose adjustments to preserve therapeutic benefit while minimizing risk. Looking beyond currently approved therapies, a growing pipeline of investigational agents holds the potential to modify disease course as evidenced by emerging endpoints such as spleen volume reduction and overall survival benefit. This program will review evidence-based and practical frameworks needed for oncology pharmacists to individualize therapy selection, optimize toxicity management, and anticipate the evolving myelofibrosis treatment landscape.
Target audience: Oncology pharmacists
Type of activity: Application
Release date: April 28, 2026
Expiration date: April 28, 2027
Learner level: Advanced
Time to complete activity: 1.0 hour
Fee: Free
Educational Objectives
At the completion of this activity, participants will be able to:
- Examine current and emerging therapeutic options for myelofibrosis to guide patient selection and evidence-based sequencing across diverse clinical presentations
- Adapt dosing strategies, titration schedules, and drug–drug interactions to guide safe transitions between JAK inhibitors
- Apply evidence-based strategies to optimize dosing, enhance efficacy, and prevent, monitor, and manage treatment-related adverse effects associated with current and emerging myelofibrosis therapies
- Analyze recent clinical trial data of emerging therapies for myelofibrosis to inform treatment selection, counsel stakeholders, and prepare for their integration into clinical practice
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