Ruxolitinib discontinuation in polycythemia vera: Patient characteristics, outcomes, and salvage strategies from a large multi-institutional database.

Autor: Tremblay D; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States., Ronner L; Department of Medicine, Hospital of the University of Pennsylvania, United States., Podoltsev N; Department of Internal Medicine (Hematology), Yale University School of Medicine, New Haven, CT, United States., Gotlib J; Stanford University School of Medicine / Stanford Cancer Institute, Stanford, CA, United States., Heaney M; Columbia University Medical Center, New York, NY, United States., Kuykendall A; H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States., O'Connell C; Keck School of Medicine of University of Southern California, Los Angeles, CA, United States., Shammo JM; Department of Internal Medicine, Division of Hematology/Oncology, Rush University Medical Center, Chicago, IL, United States., Fleischman A; Irvine Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, United States., Mesa R; Department of Hematology and Oncology, Mays MD Anderson Cancer Center at UT Health San Antonio, San Antonio, TX, United States., Yacoub A; University of Kansas Cancer Center, Westwood, KS, United States., Hoffman R; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States., Moshier E; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai Tisch Cancer Institute, New York, NY, United States., Zubizarreta N; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai Tisch Cancer Institute, New York, NY, United States., Mascarenhas J; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, United States. Electronic address: john.mascarenhas@mssm.edu.
Jazyk: angličtina
Zdroj: Leukemia research [Leuk Res] 2021 Oct; Vol. 109, pp. 106629. Date of Electronic Publication: 2021 May 27.
DOI: 10.1016/j.leukres.2021.106629
Abstrakt: Ruxolitinib is approved for the treatment of patients with polycythemia vera (PV) who are intolerant or resistant to hydroxyurea. While ruxolitinib discontinuation in myelofibrosis is associated with dismal outcomes, the analogous experience in PV has not been reported. Using a large, multi-institutional database of PV patients, we identified 93 patients with PV who were treated with ruxolitinib, of whom 22 discontinued therapy. Adverse events were the primary reason for discontinuation. After a median follow-up of 18.2 months following ruxolitinib discontinuation, no patients experienced a thrombotic event. One patient died 20.8 months after discontinuation. As compared with the 71 patients who were still receiving treatment with ruxolitinib at last follow up, patients who discontinued ruxolitinib were older at time of treatment initiation (67.5 versus 64.8 years, p = 0.0058), but had similar patient and disease characteristics. After discontinuation, only 4 patients (18 %) received subsequent cytoreductive therapy, including hydroxyurea in one patient and pegylated interferon α-2a in three patients. In stark contrast to the experience in myelofibrosis, discontinuation of ruxolitinib in PV was associated with generally favorable outcomes. However, there is a lack of available salvage therapies, highlighting the need for further therapeutic development in PV.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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