Analysis of Predictive Factors for Early Response to Ruxolitinib in 320 Patients with Myelofibrosis From the Polish Adult Leukemia Group (PALG) Registry |
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| Institution: | 1. Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland;2. Hematooncology Department, Copernicus Memorial Hospital, Lodz, Lodz, Poland;3. Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz Poland;4. School of Medicine in Katowice, Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland;5. Department of Hematology, Jagiellonian University Hospital, Krakow, Ploland;6. Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland;7. Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland;8. Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland;9. Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland;10. Department of Hematology, Wroclaw Medical University, Wroclaw, Wroclaw, Poland;11. Department of Hematology, Nicolaus Copernicus Specialist Municipal Hospital, Torun, Poland;12. Hematology Department, Rydygier Memorial Hospital, Krakow, Ploland;13. Department of Internal Diseases and Hematology, Military Institute of Medicine, Warsaw, Poland;14. Department of Hematology, Teaching Hospital No 1, Rzeszow, Poland;15. Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland;16. Department of Hematology and Cancer Prevention, Chorzow, Poland;17. Hematology Department, Jan Biziel University Hospital No. 2, Bydgoszcz, Poland;1. Gilead Sciences, Inc., Foster City, CA;2. Peter MacCallum Cancer Centre, Royal Melbourne Hospital and Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC;3. University of Texas MD Anderson Cancer Center, Houston, TX;4. McMaster University, Hamilton, ON, Canada;5. H. Lee Moffitt Cancer Center, Tampa, FL;1. Hematology and Bone Marrow Transplantation Unit, Medicana International Ankara Hospital, Ankara, Turkey;2. Department of Hematology, Faculty of Medicine, Firat University, Elazig, Turkey;3. Department of Hematology, Faculty of Medicine, Ankara University, Ankara, Turkey;1. Department of Internal Medicine, Howard University Hospital, Washington, DC;2. Clive O Callender, MD Howard-Harvard Outcome Research Center, Howard University College of Medicine, Washington, DC;3. Hematology/Oncology Division, Warren Alpert Medical School of Brown University, Providence, RI;4. Hematology/Oncology Division, Department of Medicine, Howard University Hospital, Washington, DC;1. Immune Monitoring Core Laboratory, Levine Cancer Institute, Atrium Health, Charlotte, NC;2. Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC;3. Department of Hematologic Pathology, Atrium Health, Charlotte, NC;4. Department of Cancer Biostatistics, Levine Cancer Institute, Atrium Health, Charlotte, NC;5. Myeloma Service, Memorial Sloan Kettering Cancer Center, New York, NY;1. Division of Hematology, Hematologic Malignancies and Stem Cell Transplantation, University of Colorado Cancer Center, Aurora, CO;2. Department of Internal Medicine, University of Colorado School of Medicine, Aurora, CO;3. Center for Innovative Design and Analysis, Department of Biostatistics and Informatics, University of Colorado School of Public Health, CO;4. Department of Radiology, University of Colorado School of Medicine, Aurora, CO |
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| Abstract: | IntroductionRuxolitinib 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.Patients and MethodsWe 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.Results320 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.ConclusionEstablishing 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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