{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:40:40Z","timestamp":1787614840905,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RC\u20102023\u20102778976"],"award-info":[{"award-number":["RC\u20102023\u20102778976"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anemia is frequently present in patients with myelofibrosis (MF), and it may be exacerbated by treatment with the <jats:italic>JAK2<\/jats:italic>\u2010inhibitor ruxolitinib (RUX). Recently, a relevant blast phase (BP) incidence has been reported in anemic MF patients unexposed to RUX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors investigated the incidence of BP in 886 RUX\u2010treated MF patients, included in the \u201cRUX\u2010MF\u201d retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The BP incidence rate ratio (IRR) was 3.74 per 100 patient\u2010years (3.74 %p\u2010y). At therapy start, Common Terminology Criteria for Adverse Events grade 3\u20104 anemia (hemoglobin [Hb] &lt;8\u00a0g\/dL) and severe sex\/severity\u2010adjusted anemia (Hb &lt;8\/&lt;9\u00a0g\/dL in women\/men) were present in 22.5% and 25% patients, respectively. IRR of BP was 2.34 in patients with no baseline anemia and reached respectively 4.22, 4.89, and 4.93 %p\u2010y in patients with grade 1, 2, and 3\u20134 anemia. Considering the sex\/severity\u2010adjusted Hb thresholds, IRR of BP was 2.85, 4.97, and 4.89 %p\u2010y in patients with mild\/no anemia, moderate, and severe anemia. Transfusion\u2010dependent patients had the highest IRR (5.03 %p\u2010y). Progression\u2010free survival at 5\u00a0years was 70%, 52%, 43%, and 27% in patients with no, grade 1, 2, and 3\u20134 anemia, respectively (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). At 6\u00a0months, 260 of 289 patients with no baseline anemia were receiving ruxolitinib, and 9.2% had developed a grade 3\u20134 anemia. By 6\u2010month landmark analysis, BP\u2010free survival was significantly worse in patients acquiring grade 3\u20134 anemia (69.3% vs. 88.1% at 5\u00a0years, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study highlights that anemia correlates with an increased risk of evolution into BP, both when present at baseline and when acquired during RUX monotherapy. Innovative anemia therapies and disease\u2010modifying agents are warranted in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35156","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T12:25:15Z","timestamp":1703766315000},"page":"1270-1280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Incidence of blast phase in myelofibrosis patients according to anemia severity at ruxolitinib start and during therapy"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8367-5668","authenticated-orcid":false,"given":"Francesca","family":"Palandri","sequence":"first","affiliation":[{"name":"IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Istituto di Ematologia \u201cSer\u00e0gnoli\u201d  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe A.","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche Chirurgiche e Tecnologie Avanzate \u201cG.F. 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