How do you manage refractory myelofibrosis with thrombocytopenia, significant leukocytosis (>150), and ASXL1 mutation?

The answer to this question requires, first, that like any patient with a malignancy, this patient must be staged according to the clinical and laboratory data that define the clonal tumor burden of the disease in question, as well as its extent clinically. In the spirit of full transparency, my ans...