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This symptom may be present at diagnosis or develop soon after, and around half of patients with MF require red blood cell transfusions within the first year. Progression to being transfusion dependent (TD) negatively affects prognosis and quality of life. This retrospective cohort study examined treatment sequencing from MF diagnosis, and overall survival (OS) and healthcare resource utilization (HCRU) from diagnosis and by transfusion status in newly diagnosed patients with MF in Germany. Data from 2010 to 2022 were collected from the AOK PLUS statutory health insurance fund database. Transfusion status was determined during a 180-day landmark period following first anemia treatment; patients were transfusion independent (TI) if they had received no transfusion, TD if they received\u2009\u2265\u20093 transfusions within 12 weeks, and transfusion requiring (TR) if they received transfusions but did not meet TD criteria during the landmark period. Of 555 patients assessed for treatment sequencing, only 41.8% received MF therapies (Janus kinase [JAK] inhibitors, peginterferon alpha-2a, immunomodulators, hydroxycarbamide, allogeneic hematopoietic stem cell transplantation), while 69.0% received anemia-directed interventions (59.8% being blood transfusions). Among patients receiving treatment for anemia (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009233), transfusion need was associated with shorter median OS (TD: 14.9, TR: 33.3, and TI: 74.3 months after the landmark period) and higher HCRU burden. This study documented high clinical and economic burden of anemia in patients with MF within Germany, particularly among TD patients, highlighting the need for novel treatments providing better prevention of anemia in MF.\n                  <\/jats:p>","DOI":"10.1007\/s00277-026-07033-w","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:54:49Z","timestamp":1780545289000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Myelofibrosis and anemia: a German claims data analysis to describe treatment sequencing, survival outcomes, and healthcare resource utilization"],"prefix":"10.1007","volume":"105","author":[{"given":"Alexander","family":"Slowley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"d\u2019Estrub\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Neukirch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scarlette","family":"Kienzle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Junker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Wilke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim R.","family":"G\u00f6thert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"7033_CR1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1002\/ajh.26050","volume":"96","author":"A Tefferi","year":"2020","unstructured":"Tefferi A (2020) Primary myelofibrosis: 2021 update on diagnosis, risk-stratification and management. 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Tim d\u2019Estrub\u00e9 is employed by GSK and holds financial equities in GSK. Konstantin Neukirch is employed by GSK and holds financial equities in GSK. Scarlette Kienzle is employed by Ingress-Health HWM GmbH, a Cytel company. Sophia Junker was employed by Ingress-Health HWM GmbH, a Cytel company, at the time of study conduct. Shiyuan Zhang is employed by GSK and holds financial equities in GSK. Thomas Wilke is employed by the University of Wismar and worked as a consultant for Cytel at the time of study conduct. Joachim R. G\u00f6thert received payments and honoraria from GSK, Novartis, BMS, pharma & AOP Orphan Pharmaceuticals and participated on advisory boards for GSK, Novartis, BMS and AOP Orphan Pharmaceuticals.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"365"}}