Primary Myelofibrosis with Anemia and del(5q): Treatment After Lenalidomide Failure

Clinical scenario

This protocol addresses patients with primary myelofibrosis who have anemia alongside a confirmed del(5q) cytogenetic abnormality, and whose first-line treatment has not produced an adequate anemia response.

Previous line failure condition

Lenalidomide — an agent with established activity in del(5q) — was the first-line therapy in this setting. Escalation to this protocol is triggered when that treatment fails to achieve the required anemia response: cessation of transfusions in transfusion-dependent patients, or a hemoglobin increase of 2 g/dL or greater in transfusion-independent patients.

This protocol defines the structured next step following that documented failure.

Next-line approach (partial)

For primary myelofibrosis with anemia and del(5q) after lenalidomide has not met anemia response goals, the approach involves consideration of anemia-oriented clinical trials. The full protocol specifies the decision pathway, eligibility criteria, and the complete range of structured options — available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1182/blood.2022017423

Anemia. del(5q). Lenalidomide is effective in patients carrying del(5q).

Anemia-oriented clinical trials. If failure.

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