Proposals for revised International Working Group–European LeukemiaNet criteria for anemia response in myelofibrosis
Ayalew Tefferi, Giovanni Barosi, Francesco Passamonti, Juan Carlos Hernández‐Boluda, Prithviraj Bose, Konstanze Döhner, Martin Ellis, Naseema Gangat, Jacqueline S. Garcia, Heinz Gisslinger, Jason Gotlib, Paola Guglielmelli, Vikas Gupta, Claire Harrison, Elizabeth O. Hexner, Gabriela Hobbs, Jean‐Jacques Kiladjian, Steffen Koschmieder, Nicolaus Kröger, Andrew Kuykendall, Giuseppe Gaetano Loscocco, John Mascarenhas, Lucia Masárová, Ruben A. Mesa, Barbara Mora, Olatoyosi Odenike, Stephen T. Oh, Animesh Pardanani, Anand Patel, Naveen Pemmaraju, Alessandro Rambaldi, Raajit K. Rampal, Shireen Sirhan, Natasha Szuber, Moshe Talpaz, Pankit Vachhani, Alessandro M. Vannucchi, Tiziano Barbui
Abstract
ABSTRACT: With emerging new drugs in myelofibrosis (MF), a robust and harmonized framework for defining the severity of anemia and response to treatment will enhance clinical investigation and facilitate interstudy comparisons. Accordingly, the lead authors on the 2013 edition of the International Working Group-European LeukemiaNet (IWG-ELN) response criteria in MF were summoned to revise their document with the intent to (1) account for gender-specific differences in determining hemoglobin levels for eligibility criteria; (2) revise the definition of transfusion-dependent anemia (TDA) based on current restrictive transfusion practices; and (3) provide a structurally simple and easy to apply response criteria that are sensitive enough to detect efficacy signals (minor response) and also account for major responses. The initial draft of the 2024 IWG-ELN proposed criteria was subsequently circulated around a wider group of international experts and their feedback incorporated. The proposed articles include new definitions for TDA (≥3 units in the 12 weeks before study enrollment) and hemoglobin thresholds for eligibility criteria (<10 g/dL for women and <11 g/dL for men). The revised document also provides separate (TDA vs non-TDA) and graded (major vs minor response) response criteria while preserving the requirement for a 12-week period of screening and observation on treatment.