{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T06:33:43Z","timestamp":1776407623014,"version":"3.51.2"},"reference-count":76,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,11,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Myelofibrosis (MF) is the most aggressive form of Philadelphia chromosome\u2013negative myeloproliferative neoplasm, and it is complicated by severe symptom burden, thrombotic events, infections, cytopenias, and transformation to acute myeloid leukemia (AML). Ruxolitinib, the first-line therapy for symptomatic or intermediate- and high\u2013prognostic risk MF, has improved overall survival for this population. However, approximately one-half of MF patients will discontinue ruxolitinib by the first few years of therapy due to a spectrum of resistance, intolerance, relapse, or progression to blast phase disease. Danazol, erythropoietin-stimulating agents, and spleen-directed therapies can be useful in the ruxolitinib-resistant setting. In the ruxolitinib-refractory or -intolerant setting, commercial and novel therapies, either alone or in combination with ruxolitinib, have shown clinical utility. For blast-phase MF, the recent advancements in available AML therapies have increased the options with targeted and more tolerable therapies. In this article, we will discuss our paradigm for the management of relapsed\/refractory and blast-phase MF in the context of therapeutic advancements in both AML and MF.<\/jats:p>","DOI":"10.1182\/asheducation-2018.1.118","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T22:13:59Z","timestamp":1555452839000},"page":"118-126","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":13,"title":["Managing myelofibrosis (MF) that \u201cblasts\u201d through: advancements in the treatment of relapsed\/refractory and blast-phase MF"],"prefix":"10.1182","volume":"2018","author":[{"given":"Robyn M.","family":"Scherber","sequence":"first","affiliation":[{"name":"UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben A.","family":"Mesa","sequence":"additional","affiliation":[{"name":"UT Health San Antonio MD Anderson Cancer 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