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During the 64th American Society of Hematology (ASH) Annual Meeting and Exposition, the MPN Hub was pleased to speak to John Mascarenhas, Icahn School of Medicine at Mount Sinai, New York, US. We asked, Which patients with myelofibrosis (MF) could benefit the most from telomerase inhibitors? Mascarenhas opens by discussing the implications for patients with MF who are unresponsive to typical JAK inhibitor therapy, considering the unmet need in this group. Mascarenhas goes on to outline the latest data from studies on telomerase inhibitors, such as imetelstat, within this patient group, with a particular focus on the increase in median survival time and eligibility for potentially curative interventions, such as stem cell transplant.