American Society of Hematology 2026 Guidelines for the Management of Myelofibrosis in Adults

BACKGROUND: Myelofibrosis (MF) is a myeloid bone marrow malignancy with a progressive clinical course marked by disease-related symptoms, splenomegaly, cytopenias, thrombosis/hemorrhage, and a risk for blast phase transformation. Treatment recommendations are based on the burden of symptoms, prognosis of the disease, and benefits/risks of each treatment modality. METHODS: ASH formed a multidisciplinary guideline panel that included specialists in myelofibrosis and hematopoietic cell transplantation, as well 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Mayo Clinic Evidence-based Practice Center supported the guideline development process, including updating or performing systematic evidence reviews (up to January 31, 2025). The panel prioritized clinical questions and outcomes according to their importance for patients and clinicians. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment. RESULTS: The panel agreed on 10 recommendations regarding prognostic testing, indications for interferon and JAK inhibitor therapy, management of MF-associated anemia, timing of transplantation, anti-platelet therapy, and iron chelation. CONCLUSIONS: Key recommendations of these guidelines include suggestions for extended molecular genetic testing; use of JAK-inhibition in symptomatic, lower risk MF patients; therapeutic strategies for patients with MF-anemia and JAK-inhibitor induced anemia; and considerations regarding hematopoietic cell transplantation including timing of referral and optimization prior to the procedure. Key future research agendas were identified for all recommendations.

Authors

Institutions

Publication Details

Journal
Blood Advances
Published
2026-10-14
DOI
https://doi.org/10.1182/bloodadvances.2026021650
Primary Topic
Myeloproliferative Neoplasms: Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

American Society of Hematology 2026 Guidelines for the Management of Myelofibrosis in Adults

Francisca Ferrer‐Marín, Rupali Roy Bhave, Donal P. McLornan, Anthony Michael Hunter et al.
Blood Advances
Myeloproliferative Neoplasms: Diagnosis and Treatment
article

American Society of Hematology 2026 Guidelines for the Management of Myelofibrosis in Adults

Francisca Ferrer‐Marín, Rupali Roy Bhave, Donal P. McLornan, Anthony Michael Hunter, Brady Lee Stein, Arpita P. Gandhi, Alessandro Maria Vannucchi, Mohammad Hassan Murad, Olatoyosi M. Odenike, Kristen Marie Pettit, Natasha Szuber, Vikas K Gupta, Shireen Sirhan, Juan Carlos Hernández‐Boluda, Ghaith F. Abu-Zeinah, Bashar Hasan, William E. Shomali, Maya M. Abdallah, Douglas A. Tremblay, Roni Tamari, Andrew Srisuwananukorn, Gregory Alan Abel, Lisa Jenkins, Kelley Clark
article en

Abstract

BACKGROUND: Myelofibrosis (MF) is a myeloid bone marrow malignancy with a progressive clinical course marked by disease-related symptoms, splenomegaly, cytopenias, thrombosis/hemorrhage, and a risk for blast phase transformation. Treatment recommendations are based on the burden of symptoms, prognosis of the disease, and benefits/risks of each treatment modality. METHODS: ASH formed a multidisciplinary guideline panel that included specialists in myelofibrosis and hematopoietic cell transplantation, as well 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Mayo Clinic Evidence-based Practice Center supported the guideline development process, including updating or performing systematic evidence reviews (up to January 31, 2025). The panel prioritized clinical questions and outcomes according to their importance for patients and clinicians. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment. RESULTS: The panel agreed on 10 recommendations regarding prognostic testing, indications for interferon and JAK inhibitor therapy, management of MF-associated anemia, timing of transplantation, anti-platelet therapy, and iron chelation. CONCLUSIONS: Key recommendations of these guidelines include suggestions for extended molecular genetic testing; use of JAK-inhibition in symptomatic, lower risk MF patients; therapeutic strategies for patients with MF-anemia and JAK-inhibitor induced anemia; and considerations regarding hematopoietic cell transplantation including timing of referral and optimization prior to the procedure. Key future research agendas were identified for all recommendations.

Blood Advances
Northwestern University (US), Boston Medical Center (US), University College Hospital (GB), Mayo Clinic (US), Memorial Sloan Kettering Cancer Center (US), Emory University (US), Oregon Health & Science University (US), University of Michigan (US), Jewish General Hospital (CA), Princess Margaret Cancer Centre (CA), Arroyo Grande Community Hospital (US), University of Chicago (US), Hospital Clínico Universitario de Valencia (ES), Azienda Ospedaliero-Universitaria Careggi (IT), Dana-Farber Cancer Institute (US), Hospital Universitario Fundación Jiménez Díaz (ES), Weill Cornell Medicine (US), Stanford Cancer Institute, Winship Cancer Institute, Wake Forest University Health Sciences (US), University of Florence (IT), Wake Forest University (US), McGill University (CA), The Ohio State University (US), Université de Montréal (CA), Stanford University (US), Icahn School of Medicine at Mount Sinai (US)
Good health and well-being
Openalex Percentile: Top 14%
Myeloproliferative Neoplasms: Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.