Low-dose ruxolitinib (Jakafi) appears effective as treatment of patients with myelofibrosis (MF), improving splenomegaly and symptoms with a daily dose ≤ 10 mg, according to findings from a retrospective analysis.
While the high-dose group had better outcomes to therapy, the difference in spleen length reduction between high-dose group and low-dose group was minimized. This ultimately suggests that the low-dose treatment induced slow but gradual spleen responses.
The analysis, published in Annals of Hematology, aimed to explore the treatment outcomes of patients with MF using low-dose regimens of ruxolitinib compared with high-dose treatment. The study included patients in the Department of Hematology of West China Hospital of Sichuan University between July 2017 and January 2020 who had received ruxolitinib therapy, all of whom met the 2016 World Health Organization diagnostic criteria for primary MF (PMF), post-essential thrombocythemia (ET) MF, or post-polycythemia vera (PV) MF.
The initial ruxolitinib dose for patients was determined based on the baseline platelet count and patient’s willingness. The dose was adjusted during treatment according to the changes observed in the blood cell count, as well as the therapeutic effect.
Eighty-eight patients were included in the study, of which 68 had PMF, 13 post-ET MF, and 7 post-PV MF. The median time from diagnosis to the start of treatment was 0.5 months. Forty-four patients received low-dose ruxolitinib, which was ≤ 10 mg daily. In this group, 2 patients received a 5 mg dose daily, while the remaining 42 patients had received 10 mg. The dose was individually titrated in 22 patients in order to optimize the safety and efficacy, while dose adjustments mainly occurred during weeks 10 through 16 following initiation of treatment. Final titrated doses were increased in 15 patients and decreased in 7.