Photo Credit: Md Babul Hosen

Triple-negative myelofibrosis (TN-MF) affects 6% of myelofibrosis patients and is marked by aggressive clinical behavior and poor outcomes, according to data published online in Clinical Lymphoma Myeloma and Leukemia. TN-MF is characterized by molecular heterogeneity affecting RNA splicing, epigenetic modification, and signaling, leading to varied clinical presentations. The study included 626 patients at the H. Lee Moffitt Cancer Center and revealed that patients with TN-MF had a median overall survival of 37.4 months compared to 85.7 months in non-TN patients, and higher rates of leukemic transformation. TN-MF was associated with more pronounced thrombocytopenia, anemia, and lower LDH and EPO levels. Mutations in genes such as SRSF2, SETBP1, IDH2, CBL, and GNAS were more common in TN-MF, which may contribute to its aggressive nature and suboptimal response to JAK inhibitors like ruxolitinib.