For higher-risk patients with MF with severe thrombocytopenia (platelets < 50 × 109/L), pacritinib, an oral selective JAK2 and interleukin-1 receptor-associated kinase (IRAK1) inhibitor, is my preferred first-line treatment option [16, 22, 23]. This evidence concerns the gene IRAK1 and Thrombocytopenia.