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Mehak Trehan: ASH 2026 Myelofibrosis Guidelines 10 Practical Takeaways for Clinical Practice

Mehak Trehan/LinkedIn

Oct 16, 2026, 02:33

Mehak Trehan: ASH 2026 Myelofibrosis Guidelines 10 Practical Takeaways for Clinical Practice

Mehak Trehan, Subject Matter Expert at DailyRounds, shared American Society of Hematology’s post on LinkedIn:

“ASH 2026 New Myelofibrosis Guidelines: 10 practical takeaways

What should change in our clinics?

Go beyond JAK2 CALR MPL. Extended NGS at diagnosis can improve prognostication and guide treatment decisions.
Risk is more than a score. Integrate clinical and molecular risk when planning treatment and transplant assessment.
Symptomatic, lower risk MF? JAK inhibitors have a role. Lower risk doesnt mean symptoms should go untreated.
Asymptomatic, higher risk MF? Dont initiate JAK inhibitors solely because of the risk category.
Monitor what matters. Assess spleen size, symptom burden and cytopenias serially, NOT just CBC.
Anemia needs its own strategy. Differentiate disease related from treatment related anemia and address reversible causes.
Individualize JAK inhibitor therapy. Anemia, thrombocytopenia and symptom control should influence drug selection and treatment adjustments.
Refer early for allo HCT. In higher risk MF, even a good JAK inhibitor response should not delay transplant consultation.
JAK2 V617F positive MF: Consider low dose aspirin for primary thrombosis prevention, provided bleeding risk is acceptable. Not a blanket rule for all MF.
Keep reassessing. Disease evolution, changing symptoms, cytopenias and molecular risk may alter the treatment plan.

Indian perspective

The challenge isnt just knowing the guidelines, its implementing them.

Extended NGS, timely transplant referrals& access to newer JAK inhibitors remain uneven and often cost dependent.

For us, the priorities are clear:Risk stratify early. Refer for transplant early. Individualize treatment according to both disease biology and affordability.

And importantly, most recommendations are conditional, not one size fits all.”

American Society of Hematology shared a post on LinkedIn:

“ASH has published new evidence based guidelines to help address decision making gaps in the care of myelofibrosis.

The guidelines address routine questions from clinicians and patients while also identifying where stronger evidence is needed to continue improving outcomes for patients.

The 10 recommendations include guidance on:

Expanded molecular testing
Early transplant referral
Appropriate use of JAK inhibitors
Aspirin therapy in select patients.

The guidelines were published today in Blood Journals Portfolio

Learn more about the guidelines, including the development process and what patients need to know.” Mehak Trehan: ASH 2026 Myelofibrosis Guidelines 10 Practical Takeaways for Clinical Practice