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A Prognostic Model to Predict Ruxolitinib Discontinuation and Death in Patients with Myelofibrosis
Francesca Palandri1, Giuseppe A Palumbo2, Massimiliano Bonifacio3
1IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", 40138 Bologna, Italy.
Cancers
|October 28, 2023
Summary
Most myelofibrosis patients stop ruxolitinib early due to treatment failure. A new prognostic model identifies patients at high risk for early discontinuation, guiding alternative frontline strategies for better outcomes.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Myelofibrosis (MF) is a myeloproliferative neoplasm.
- Ruxolitinib is a JAK1/JAK2 inhibitor used for MF treatment.
- Many patients discontinue ruxolitinib within 5 years due to therapy failure.
Purpose of the Study:
- To identify predictors of early ruxolitinib discontinuation and death in MF patients.
- To develop a prognostic model for predicting short-term ruxolitinib therapy (STR).
Main Methods:
- Retrospective analysis of 889 MF patients from the "RUX-MF" study.
- Multivariate analysis to identify predictors of STR.
- Development of a prognostic model (STR-PM) based on significant variables.
Main Results:
- Low platelet count, low hemoglobin, primary MF, no spleen response at 3 months, and low starting dose of ruxolitinib predicted STR.
- The STR-PM model identified low, intermediate, and high-risk groups for ruxolitinib failure.
- Long-term ruxolitinib (LTR) patients had significantly longer overall survival compared to STR patients.
Conclusions:
- The STR-PM can identify MF patients likely to experience early ruxolitinib monotherapy failure.
- These patients may benefit from alternative frontline treatment strategies.
- Early identification of high-risk patients is crucial for optimizing MF management.
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