Table 2.

Treatment strategies for anaemia.

Drugs	Dosage	Pros	Cons
Corticosteroids (eg, prednisone)25	0.5 mg/kg/day	Commonly used in combination with other therapies	Only temporarily effective
Erythropoiesis-stimulating agents (eg, darbepoetin-alfa)26	150 µg/wk	Are worth trying in patients with MF with moderate, nontransfusion-dependent anaemia	A low serum erythropoietin level (<125 IU/L) is required. Are not indicated in anaemic subjects with established transfusion dependency
Danazol27–30	600 mg daily for patients weighing up to 80 kg and 800 mg daily for those weighing >80 kg	Stimulate erythropoiesis in patients with refractory anaemia, leading to increased haemoglobin level and decreased need for transfusions	Toxicities include fluid retention, increased libido, liver function test abnormalities, headache, and virilisation
Thalidomide32	50 mg/day	Some responses in patients with anaemia, thrombocytopenia, and splenomegaly	High incidence of neuropathy. Not usually selected for first-line management of anaemia
Lenalidomide33–35	10 mg/day (5 mg/day if platelet count is <100 × 109/L) in 28-day cycles on a 21-day on/7-day off schedule	More effective than thalidomide-based therapy. Longer response duration in patients receiving lenalidomide plus prednisone	Toxicities mainly include cytopenias
Pomalidomide37	0.5 mg/day	Significantly better platelet response	No advantage in anaemia response