Clinical Manifestations and Prognostic Impact of Anemia in Myelofibrosis

Myelofibrosis presents with a wide spectrum of manifestations driven by impaired marrow function and systemic inflammation. Patients commonly experience splenomegaly, constitutional symptoms, bone pain, and progressive cytopenias, with anemia being one of the most burdensome features. Anemia contributes to profound fatigue, reduced functional capacity, and increased dependence on caregivers, often limiting daily activities and diminishing quality of life. From a prognostic standpoint, several clinical and molecular factors—including advanced age, leukocytosis, thrombocytopenia, high-risk mutations, and transfusion dependence—identify patients at greater risk for poor outcomes. Among these, anemia is a key adverse prognostic marker. Its presence often signals more advanced disease biology, correlates with shortened survival, and is incorporated into major risk-stratification models. As a result, addressing anemia remains central to both symptom management and long-term disease assessment in myelofibrosis.