Impact of Hemoglobin Improvement on Survival in Patients With Myelofibrosis and Anemia Treated With Momelotinib in the SIMPLIFY-1 and MOMENTUM Trials.
Francesca Palandri, Casey O'Connell, Pankit Vachhani et al.
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In 30 seconds
These post hoc analyses of two phase 3 randomised trials examined how quickly patients with myelofibrosis and baseline hemoglobin < 10 g/dL achieved hemoglobin ≥ 10 g/dL with momelotinib, and whether this was associated with survival. By week 24, the threshold was reached by 54/86 patients (63%) in SIMPLIFY-1 and 45/126 (36%) in MOMENTUM. Achievement was numerically associated with longer survival in both trials, but multivariate analysis found only week 24 transfusion independence associated with survival.
Key findings
- In SIMPLIFY-1, 54/86 patients (63%) achieved hemoglobin ≥ 10 g/dL by week 24; in MOMENTUM, 45/126 (36%) did.
- Achievement of hemoglobin ≥ 10 g/dL was numerically associated with longer survival: SIMPLIFY-1 HR, 0.53 (95% CI, 0.27-1.05); MOMENTUM HR, 0.62 (95% CI, 0.33-1.15).
- In multivariate analysis, only week 24 transfusion independence was associated with survival.
- Patients with moderate anemia and/or no prior JAK inhibitor experience were more likely or faster to reach the hemoglobin threshold.
Why it matters
The analyses suggest that hemoglobin improvement may be a clinically meaningful treatment outcome in momelotinib-treated myelofibrosis, while also showing that its relationship with survival is uncertain. The distinction between a numerical survival association and an independently associated factor is important when interpreting hemoglobin response as a prognostic marker.
What to keep in mind
These were post hoc analyses, and the reported survival associations were numerical; hemoglobin achievement was not independently associated with survival in multivariate analysis.