In the absence of symptoms would you still treat high risk myelofibrosis if transplant ineligible?

If a patient with high risk PMF is not a transplant candidate, any therapy is, by definition, palliative and in the absence of symptoms, the potential risks of therapy would theoretically outweigh its benefits (e.g., anemia, leukopenia, or thrombocytopenia). The presence of asymptomatic leukocytosis and thrombocytosis, alone or together, is never a reason for cytoreduction since they are not associated with thrombosis - a missed diagnosis of polycythemia vera is. Cytoreduction with hydroxyurea i...