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Peripheral blasts are associated with responses to ruxolitinib and outcomes in patients with chronic‐phase myelofibrosis
Author(s) -
Palandri Francesca,
Bartoletti Daniela,
Iurlo Alessandra,
Bonifacio Massimiliano,
Abruzzese Elisabetta,
Caocci Giovanni,
Elli Elena M.,
Auteri Giuseppe,
Tiribelli Mario,
Polverelli Nicola,
Miglino Maurizio,
Heidel Florian H.,
Tieghi Alessia,
Benevolo Giulia,
Beggiato Eloise,
Fava Carmen,
Cavazzini Francesco,
Pugliese Novella,
Binotto Gianni,
Bosi Costanza,
Martino Bruno,
Crugnola Monica,
Ottaviani Emanuela,
Micucci Giorgia,
Trawinska Malgorzata M.,
Cuneo Antonio,
Bocchia Monica,
Krampera Mauro,
Pane Fabrizio,
Lemoli Roberto M.,
Cilloni Daniela,
Vianelli Nicola,
Cavo Michele,
Palumbo Giuseppe A.,
Breccia Massimo
Publication year - 2022
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.34216
Subject(s) - ruxolitinib , myelofibrosis , medicine , discontinuation , gastroenterology , overall survival , bone marrow
Background The presence of peripheral blasts (PB) is a negative prognostic factor in patients with primary and secondary myelofibrosis (MF) and PB ≥4% was associated with a particularly unfavorable prognosis. Ruxolitinib (RUX) is the JAK1/2 inhibitor most used for treatment of MF‐related splenomegaly and symptoms. Its role has not been assessed in correlation with PB. Methods In 794 chronic‐phase MF patients treated with RUX, we evaluated the impact of baseline percentage of PB on response (spleen and symptoms responses) and outcome (RUX discontinuation‐free, leukemia‐free, and overall survival). Three subgroups were compared: PB‐0 (no PB, 61.3%), PB‐4 (PB 1%‐4%, 33.5%), and PB‐9 (PB 5%‐9%, 5.2%). Results At 3 and 6 months, spleen responses were less frequently achieved by PB‐4 ( P = .001) and PB‐9 ( P = .004) compared to PB‐0 patients. RUX discontinuation‐free, leukemia‐free, and overall survival were also worse for PB‐4 and PB‐9 patients ( P = .001, P = .002, and P < .001, respectively). Conclusions Personalized approaches beyond RUX monotherapy may be useful in PB‐4 and particularly in PB‐9 patients.