That feeling began to slip in 2018. A lifelong morning person, Mary suddenly found herself waking up fatigued. “I started to feel tired in the summer of 2018,” she says. At first, she thought it was a bad night’s sleep, but this was something different: the feeling did not completely go away, even when she would rest. “I was fatigued to the point that it felt like I was walking through mud up to my waist.”Her doctors eventually diagnosed her with myelofibrosis (MF) with anemia, a rare and complex blood cancer. It affects the bone marrow (the part of your body that makes blood cells). In people with myelofibrosis, there is inflammation and scarring of the bone marrow, which is called fibrosis. This leads to abnormal production of blood cells.
Mary finally received an explanation for what she was experiencing: myelofibrosis with anemia, which refers to a low red blood cell count and is one of the symptoms people with MF may express.
Additional symptoms of MF can include:
- Enlarged spleen (splenomegaly) – it may make you feel full too quickly or have pain under your left rib
- Low platelet count (thrombocytopenia) – which can cause problems like bleeding or bruising easily
- Other symptoms – night sweats, pain under the left rib, weight loss, fatigue, tiredness, abdominal pain, itching, or bone paini
*These are not all of the signs and symptoms that people may experience, as each person experiences myelofibrosis differently. It is important to keep track of any new or worsening symptoms and share those with your healthcare provider.
Recognizing fatigue beyond tiredness
Mary admits she once misunderstood fatigue. “I now know the difference between fatigue and being tired,” she explains.
For Mary, unlike ordinary tiredness, the fatigue she experienced when diagnosed with MF with anemia made some of her everyday tasks seem overwhelming. “I didn’t always have the strength to get up, and it got really scary when that happened,” she recalls.
The road to diagnosis
Mary’s turning point came after dinner at a friend’s house, when she became very ill. She happened to have a colonoscopy scheduled for the following week where she told the doctor that something felt very wrong which led her gastroenterologist to suggest bloodwork. “My gastroenterologist told me, ‘You don’t need to see me. You need to see an oncologist,’” she says. “When the oncologist said it was blood cancer, I was stunned.”
Navigating her diagnosis was difficult. The influx of new information and technical terminology around her diagnosis was overwhelming, but with the help of her oncology team, she could see a clearer path. “I realized I needed to do what I could to familiarize myself with the disease. This is a long haul.”
Living with symptoms
For Mary, MF with anemia stripped away some of the activities she loved most. She also experienced pain in her spleen.
“It became surprisingly uncomfortable. I had to stop doing yoga poses, and I couldn’t sleep on my left side,” she explains.
An appropriate treatment option for Mary
Eventually, a specialist recommended OJJAARA (momelotinib) 200 mg, 150 mg, 100 mg tablets, a prescription medicine and the first and only FDA treatment option for adults who have certain types of MF with anemia.ii
OJJAARA may cause serious side effects, including risk of infections, severe skin reactions and blood clots that can each be life-threatening, low platelet and white blood cell counts, liver problems and new cancers. Other serious side effects include major cardiovascular events such as heart attack, stroke and death. Get emergency help right away if you have chest pain — pressure or tightness in your chest that may spread to your jaw, neck or left arm, feeling dizzy, faint or lightheaded, nausea or vomiting, indigestion or heartburn, breaking out in a cold sweat, shortness of breath or difficulty breathing, weakness in one part or on one side of body and slurred speech. These are not all the possible symptoms of a heart attack or stroke. Please review the Important Safety Information below and the full Prescribing Information to learn more.ii
“The specialist recommended OJJAARA, because it was the appropriate treatment for my myelofibrosis with anemia,” Mary recalls. “He told me this was the treatment for me.”
By late 2023, she was able to start treatment. Since then, Mary has said she has noticed changes in how she goes about her days and activities that she doesn’t take for granted.
“I still have to manage my energy. I need to rest occasionally during the day. But I can sit down for a few minutes and get back up again,” she says.
Moving forward
Mary’s experience illustrates how MF symptoms — such as anemia, an enlarged spleen, or low platelet count — can affect daily life in unique ways. Because symptoms vary so widely from person to person, talking openly with healthcare providers is key to finding the right support and treatment plan.
Because MF is rare and often difficult to diagnose, stories like Mary’s can help raise awareness of what the disease may look like in daily life. Her hope is that others don’t brush aside the signs and symptoms. “If something feels off, don’t just push through it. Talk to your doctor,” she says. To hear Mary describe her journey firsthand, watch her full story in the video here.
If you or a loved one are living with MF with anemia, talk to your healthcare provider. Visit OJJAARA.com to learn more about an available treatment option and talk with your healthcare provider about whether OJJAARA may be an appropriate treatment option.
Mary is a real patient taking OJJAARA when this article was published. Mary was compensated by GSK for her work on this project.
APPROVED USE
OJJAARA is a prescription medicine used to treat adults with certain types of myelofibrosis (MF) who have anemia. It is not known if OJJAARA is safe and effective in children.
IMPORTANT SAFETY INFORMATION
OJJAARA may cause serious side effects, including:
- Risk of Infections. People who take OJJAARA may develop serious infections that can lead to death, such as bacterial and viral infections, including COVID-19. If you have an active infection, your healthcare provider should not start treatment with OJJAARA until your infection is gone. If you have had hepatitis B for a long time (chronic), OJJAARA may cause your hepatitis B to become active again, and your healthcare provider will check your blood for active hepatitis B before starting treatment. Your healthcare provider will monitor you and treat you for any infections that you get during treatment with OJJAARA. Tell your healthcare provider right away if you develop any of the following symptoms of infection:
- fever
- chills
- cough
- breathing problems
- diarrhea
- vomiting
- pain or burning feeling when passing urine
- Low platelet and white blood cell counts. OJJAARA may cause new or worsening low platelet and white blood cell counts. Low platelet counts may increase your risk for bleeding and low white blood cell counts may increase your risk for infection. Your healthcare provider will do blood tests to check your blood counts before you start taking OJJAARA and during treatment. Tell your healthcare provider right away if you have any signs of bleeding during treatment with OJJAARA, including:
- unusual bleeding
- black or tarry stools
- bruising
- Liver problems. OJJAARA may cause new or worsening increased liver enzymes and bilirubin in your blood. Your healthcare provider will check your liver enzymes before starting treatment, every month for the first 6 months of treatment, and then as needed during treatment with OJJAARA. Your healthcare provider may stop treatment with OJJAARA if your liver enzymes increase. Tell your healthcare provider if you develop any of the following signs or symptoms of liver problems:
- tiredness
- loss of appetite
- pain in your right upper stomach area (abdomen)
- dark urine
- yellowing of your skin or the white part of your eyes
- Severe skin reactions. Severe skin reactions that can be life-threatening have occurred with OJJAARA. Tell your healthcare provider or get medical help right away if you get any of the following signs or symptoms of severe skin reactions, with or without fever:
- rash that keeps getting worse
- severe rash
- reddened skin
- flu-like symptoms
- skin pain or burning
- blistering of the lips, eyes or mouth
- blisters on the skin
- skin peeling
- Major cardiovascular events such as heart attack, stroke, and death. Major cardiac events have happened, especially in people with cardiac risk factors and who are current or past smokers, taking another Janus kinase (JAK) inhibitor to treat rheumatoid arthritis. OJJAARA is in the JAK family of medicines. Get emergency help right away if you have any symptoms of a heart attack or stroke while taking OJJAARA, including:
- discomfort in your chest that lasts for more than a few minutes, or that goes away and comes back
- severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw
- pain or discomfort in your arms, back, neck, jaw, or stomach
- shortness of breath with or without chest discomfort
- breaking out in a cold sweat
- nausea or vomiting
- feeling lightheaded
- weakness in one part or on one side of your body
- slurred speech
- Blood clots. Blood clots in the veins of the legs (deep vein thrombosis, DVT) or lungs (pulmonary embolism, PE) have happened in some people taking another JAK inhibitor to treat rheumatoid arthritis, and may be life-threatening. Tell your healthcare provider if you have had blood clots in the veins of your legs or lungs in the past. Tell your healthcare provider right away if you have any signs and symptoms of blood clots during treatment with OJJAARA, including:
- swelling, pain or tenderness in one or both legs
- sudden, unexplained chest pain
- shortness of breath or difficulty breathing
- New cancers. New cancers, including lymphoma and other cancers, except non-melanoma skin cancer, have happened in some people taking another JAK inhibitor to treat rheumatoid arthritis. The risk of new cancers is further increased in people who smoke or who smoked in the past.
The most common side effects of OJJAARA include:
- low platelet count
- bleeding
- bacterial infection
- tiredness
- dizziness
- diarrhea
- nausea
These are not all the possible side effects of OJJAARA. Call your doctor for medical advice about side effects.
Before taking OJJAARA, tell your healthcare provider about all your medical conditions, including if you:
- have an infection
- have or have had hepatitis B
- have or have had liver problems
- have had a heart attack, or have or have had other heart problems, or stroke
- have or have had a blood clot
- smoke or were a smoker in the past
- have or have had any other cancers
- are pregnant or plan to become pregnant. OJJAARA may harm your unborn baby.
Females who are able to become pregnant:
- You should use effective birth control (contraception) during treatment and for 1 week after the last dose of OJJAARA.
- Tell your healthcare provider right away if you think you are pregnant or become pregnant during treatment with OJJAARA.
- are breastfeeding or plan to breastfeed. It is not known if OJJAARA passes into your breast milk. You should not breastfeed during treatment and for 1 week after the last dose of OJJAARA. Talk to your healthcare provider about the best way to feed your baby during this time.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking OJJAARA with certain other medicines may affect the amount of OJJAARA or the other medicines in your blood and may increase your risk of side effects.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. You may also report negative side effects to GSK at https://gsk.public.reportum.com or 1-888-825-5249.
Please see full Prescribing Information, including Patient Information for patients.
To learn more about this treatment option, visit OJJAARA.com.
Trademarks are owned by or licensed to the GSK group of companies.
©2025 GSK or licensor.
PMUS-MMLCOCO250003 November 2025
Produced in USA. Intended for US audiences only.
i Myelofibrosis: Symptoms, types, prognosis & treatment. Cleveland Clinic. (2024, May 1). https://my.clevelandclinic.org/health/diseases/15672-myelofibrosis
ii GlaxoSmithKline. (2025) OJJAARA [package insert]
