Ruxolitinib, approved in 2011 for myelofibrosis (MF), is key in treating MF and polycythemia vera (PV). Despite its benefits, some patients don't respond or stop due to mutations or progression. Recent studies at ASH 2024 explored combinations like pelabresib, bomedemstat, and elritercept with ruxolitinib, showing promise in improving symptoms, spleen volume reduction, and addressing cytopenias in MF patients.