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Tuberculosis Peritonitis During Treatment of Polycythemia Vera with Ruxolitinib

Emiko Sakiyama1, Yoshiaki Chinen1, Taku Tsukamoto1

  • 1Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Infection and Drug Resistance
|April 21, 2020
PubMed

Insights

Ruxolitinib treats myeloproliferative neoplasms but can increase infection risk. This case highlights tuberculosis peritonitis as a rare but serious complication in polycythemia vera patients on ruxolitinib therapy.

Area of Science:

  • Oncology
  • Immunology
  • Infectious Diseases

Background:

  • Ruxolitinib is a Janus kinase (JAK) 1/2 inhibitor approved for myeloproliferative neoplasms (MPNs).
  • MPNs include myelofibrosis and polycythemia vera (PV).
  • Ruxolitinib's immunosuppressive effects may elevate opportunistic infection risks, including Mycobacterium tuberculosis (MTB).

Observation:

  • A 76-year-old male with PV developed tuberculosis peritonitis.
  • The patient was undergoing ruxolitinib therapy for 28 weeks.
  • This is the first reported case of tuberculosis peritonitis in an MPN patient treated with ruxolitinib.

Findings:

  • Previous reports indicate an increased risk of MTB infections in various organs during ruxolitinib treatment for MPNs.
  • The median time from ruxolitinib initiation to MTB emergence is 20 weeks (range: 3-88 weeks).
  • Tuberculosis peritonitis should be considered in MPN patients on ruxolitinib presenting with abdominal infectious symptoms.

Implications:

  • Clinicians should maintain vigilance for MTB infections, including tuberculosis peritonitis, early in ruxolitinib treatment.
  • Early diagnosis and management are crucial for patients with MPN receiving ruxolitinib.
  • This case underscores the importance of monitoring for opportunistic infections during targeted cancer therapies.
Keywords:
polycythemia veraruxolitinibtuberculosis peritonitis

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