鲁索利替尼
骨髓纤维化
医学
骨髓增生性肿瘤
内科学
白细胞增多症
血液学
体质症状
置信区间
胃肠病学
骨髓
疾病
作者
Joanna Góra Tybor,Aleksandra Gołoś,Damian Mikulski,Grzegorz Helbig,Tomasz Sacha,Krzysztof Lewandowski,Joanna Niesiobędzka-Krężel,Maria Bieniaszewska,Hubert Wysogląd,Olga Grzybowska‐Izydorczyk,Ilona Seferyńska,Marta Sobas,Maria Czyżewska,Agnieszka Michalska,Waldemar Sawicki,Malwina Mazur,Marek Hus,Ewa Bodzenta,Magdalena Olszewska-Szopa,Martyna Włodarczyk,Elżbieta Patkowska,Wojciech Świstek,Krzysztof Jamroziak
标识
DOI:10.1016/j.clml.2022.10.002
摘要
Ruxolitinib is widely used in myelofibrosis (MF). However, some patients do not optimally respond and require more efficacious treatment. Our analysis aimed to establish predictors of ruxolitinib response.We designed a multicenter, retrospective analysis of the efficacy of ruxolitinib treatment in patients with MF in 15 Polish hematology centers. As responses to ruxolitinib occur within the first 6 months, we used this point to evaluate the efficacy of treatment. Symptoms response was defined as ≥50% reduction of the MF constitutional symptoms assessed by Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score (MPN-SAF TSS). Spleen response was defined as ≥50% reduction of the difference between the spleen's baseline length and the upper limit norm measured by ultrasonography.320 MF patients were enrolled. At 6 months of therapy, the spleen response was detected in 140 (50%) patients, and symptoms response in 241 patients (76%). Multivariable analysis identified leukocytosis <25 G/L (OR 2.06, 95%CI: 1.12-3.88, P = .0200), and reticulin fibrosis MF 1 (OR 2.22, 95%CI: 1.11-4.46, P = .0249) contributed to better spleen response. The time interval between MF diagnosis and ruxolitinib administration shorter than 3 months, and platelets ≥150 G/L (OR 1.69, 95% CI 1.01-2.83, P = .0466) influenced symptoms response.Establishing predictive factors for ruxolitinib response is particularly important given the potential for new therapies in MF. In patients with a low likelihood of responding to ruxolitinib, using other JAK inhibitors or adding a drug with a different mechanism of action to ruxolitinib may be of clinical benefit.
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