Treating Anemia in Myelofibrosis With Repurposed Drugs (Nelfinavir) That Restore Iron Delivery to the Bone Marrow
Key claim: A phase I/II trial is investigating whether nelfinavir, a repurposed HIV protease inhibitor, can improve anemia and reduce serum fibrosis biomarkers in myelofibrosis patients by restoring iron delivery to the bone marrow.
Abstract
This is a phase I/II protocol investigating whether Nelfinavir can improve anemia and lower serum fibrosis biomarkers in Myelofibrosis patients.
Why this matters
Anemia is one of the principal drivers of fatigue in myelofibrosis, and existing supportive options (ESAs, danazol, luspatercept, transfusions) are limited in efficacy and durability. A repurposed protease inhibitor that works by restoring iron delivery to the marrow would represent a mechanistically distinct lever on the anemia–fatigue axis, potentially offering symptom relief independent of JAK inhibition or disease-modifying therapy.