Blood Advances
American Society of Hematology 2026 Guidelines for the Management of Myelofibrosis in Adults
By Brady Lee Stein, Maya M. Abdallah, Gregory Alan Abel and 21 others.
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.