A Prognostic Model to Predict Ruxolitinib Discontinuation and Death in Patients with Myelofibrosis.

Autor: Palandri F; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', 40138 Bologna, Italy., Palumbo GA; Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate 'G.F. Ingrassia', University of Catania, 95124 Catania, Italy., Bonifacio M; Department of Engineering for Innovation Medicine, Section of Innovation Biomedicine, Hematology Area, University of Verona, 37129 Verona, Italy., Elli EM; Hematology Division, Fondazione IRCCS, San Gerardo dei Tintori, 20900 Monza, Italy., Tiribelli M; Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy., Auteri G; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', 40138 Bologna, Italy.; Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy., Trawinska MM; Division of Hematology, Sant'Eugenio Hospital, Tor Vergata University, 00133 Rome, Italy., Polverelli N; Unit of Blood Diseases and Stem Cells Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili of Brescia, 25121 Brescia, Italy., Benevolo G; Città della Salute e della Scienza Hospital, University Hematology Division, 10126 Torino, Italy., Tieghi A; Department of Hematology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy., Cavalca F; Hematology Division, Fondazione IRCCS, San Gerardo dei Tintori, 20900 Monza, Italy., Caocci G; Hematology Unit, Department of Medical Sciences, University of Cagliari, 09124 Cagliari, Italy., Beggiato E; Città della Salute e della Scienza Hospital, University Hematology Division, 10126 Torino, Italy., Binotto G; Unit of Hematology and Clinical Immunology, University of Padova, 35122 Padova, Italy., Cavazzini F; Division of Hematology, University of Ferrara, 44121 Ferrara, Italy., Miglino M; Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, 16126 Genova, Italy.; IRCCS Policlinico San Martino, 16132 Genova, Italy., Bosi C; Division of Haematology, AUSL di Piacenza, 29121 Piacenza, Italy., Crugnola M; Division of Hematology, Azienda Ospedaliero, Universitaria di Parma, 43126 Parma, Italy., Bocchia M; Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy., Martino B; Division of Hematology, Azienda Ospedaliera 'Bianchi Melacrino Morelli', 89124 Reggio Calabria, Italy., Pugliese N; Department of Clinical Medicine and Surgery, Hematology Section, University of Naples 'Federico II', 80138 Naples, Italy., Venturi M; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', 40138 Bologna, Italy.; Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy., Isidori A; Haematology and Haematopoietic Stem Cell Transplant Center, AORMN Hospital, 61100 Pesaro, Italy., Cattaneo D; Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., Krampera M; Department of Engineering for Innovation Medicine, Section of Innovation Biomedicine, Hematology Area, University of Verona, 37129 Verona, Italy., Pane F; Department of Clinical Medicine and Surgery, Hematology Section, University of Naples 'Federico II', 80138 Naples, Italy., Cilloni D; Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy., Semenzato G; Unit of Hematology and Clinical Immunology, University of Padova, 35122 Padova, Italy., Lemoli RM; Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, 16126 Genova, Italy.; IRCCS Policlinico San Martino, 16132 Genova, Italy., Cuneo A; Division of Hematology, University of Ferrara, 44121 Ferrara, Italy., Abruzzese E; Division of Hematology, Sant'Eugenio Hospital, Tor Vergata University, 00133 Rome, Italy., Branzanti F; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', 40138 Bologna, Italy., Vianelli N; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', 40138 Bologna, Italy., Cavo M; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', 40138 Bologna, Italy.; Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy., Heidel F; Internal Medicine II, Hematology and Oncology, Friedrich-Schiller-University Medical Center, 07747 Jena, Germany., Iurlo A; Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., Breccia M; Department of Translational and Precision Medicine, Sapienza University, 00185 Rome, Italy.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Oct 17; Vol. 15 (20). Date of Electronic Publication: 2023 Oct 17.
DOI: 10.3390/cancers15205027
Abstrakt: Most patients with myelofibrosis (MF) discontinue ruxolitinib (JAK1/JAK2 inhibitor) in the first 5 years of therapy due to therapy failure. As the therapeutic possibilities of MF are expanding, it is critical to identify patients predisposed to early ruxolitinib monotherapy failure and worse outcomes. We investigated predictors of early ruxolitinib discontinuation and death on therapy in 889 patients included in the "RUX-MF" retrospective study. Overall, 172 patients were alive on ruxolitinib after ≥5 years (long-term ruxolitinib, LTR), 115 patients were alive but off ruxolitinib after ≥5 yrs (short-term RUX, STR), and 123 patients died while on ruxolitinib after <5 yrs (early death on ruxolitinib, EDR). The cumulative incidence of the blast phase was similar in LTR and STR patients ( p = 0.08). Overall survival (OS) was significantly longer in LTR pts ( p = 0.002). In multivariate analysis, PLT < 100 × 10 9 /L, Hb < 10 g/dL, primary MF, absence of spleen response at 3 months and ruxolitinib starting dose <10 mg BID were associated with higher probability of STR. Assigning one point to each significant variable, a prognostic model for STR (STR-PM) was built, and three groups were identified: low (score 0-1), intermediate (score 2), and high risk (score ≥ 3). The STR-PM may identify patients at higher risk of failure with ruxolitinib monotherapy who should be considered for alternative frontline strategies.
Databáze: MEDLINE
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