Persistent foot ulcer due to ruxolitinib therapy for primary myelofibrosis

Area of Science:

• Hematology
• Oncology
• Dermatology

Background:

• Primary myelofibrosis is a myeloproliferative neoplasm characterized by bone marrow fibrosis and splenomegaly.
• The Janus kinase (JAK) inhibitor ruxolitinib is a standard treatment for symptomatic primary myelofibrosis.
• The JAK-2 V617F mutation is present in over 90% of primary myelofibrosis patients.

Observation:

• A case of persistent foot ulcer development is described.
• The foot ulcer was attributed to ruxolitinib therapy in a patient with primary myelofibrosis.

Findings:

• This is the first reported instance of foot ulcers associated with ruxolitinib treatment in scientific literature.
• The exact mechanism linking ruxolitinib to foot ulcer development remains unclear.

Implications:

• Pre-treatment examination of lower extremities may be warranted before initiating ruxolitinib.
• If ruxolitinib discontinuation is not feasible, diligent wound care and antibiotic treatment are crucial for managing these ulcers.