How I treat MF in the JAK inhibitor era. The DIPSS can be used for risk stratification at any time point during the course of MF. Prognostic variables are each assigned a score of 1 point, except for anemia, which is assigned a score of 2 points. These variables include: age > 65 years, anemia (defined as hemoglobin < 10 g/dL), WBC count > 25 × 10⁹/L, circulating blasts ≥ 1%, and constitutional systems. The recommended treatment algorithm according to risk stratum categories (low, intermediate 1 [Int-1]; intermediate 2 [Int-2], and high) is summarized in the figure. Early referral for allogeneic stem cell transplantation and/or enrollment in clinical trials is recommended for symptomatic or higher risk patients with significant cytopenias (hemoglobin < 10 g/dL, platelet count < 100 K/μL) and/or prior JAK inhibitor exposure. In the absence of an appropriate clinical trial, ImiD agents, androgenic steroids, or erythropoietin-stimulating agents can be considered, particularly for anemic patients.