Clinical practice recommendations for myelofibrosis management in Latin America from an expert consensus group

• An expert panel of hematologists from LATAM developed recommendations to address region-specific challenges in MF care. • Themes covered treatment options, Janus kinase inhibitors, risk stratification, and allogeneic hematopoietic stem cell transplantation. Myelofibrosis (MF) is a rare myeloproliferative neoplasm associated with significant health burden, and limited access to newer therapies for MF in Latin America (LATAM) creates a significant barrier to optimal care. With this challenge in mind, an expert panel of 8 hematologists from the LATAM region developed evidence- and consensus-based clinical practice recommendations to standardize care and improve outcomes for patients with MF in the LATAM region. Using modified Delphi methodology, 5 key themes were addressed: (1) defining the thresholds for anemia and when to initiate or modify treatment; (2) defining when to initiate or modify treatment for thrombocytopenia; (3) Janus kinase inhibitor therapy: selection, initiation, and switching; (4) defining the most appropriate risk stratification model for MF in the LATAM region; and (5) defining allogeneic hematopoietic stem cell transplantation eligibility in the LATAM region. LATAM-specific and global systematic literature reviews were utilized alongside the clinical experience of the authors to draft recommendations. An extended faculty of 20 LATAM hematologists were invited to vote on the recommendations, which all achieved a high level of consensus. Although the presented recommendations aim to optimize MF care in the LATAM region, broader access to newer, more effective therapies for MF is essential to significantly improve patient outcomes in LATAM.