Hematocrit control and thrombotic risk in patients with polycythemia vera treated with ruxolitinib in clinical practice.

Hematocrit Myeloproliferative disorders Polycythemia vera Retrospective studies Ruxolitinib Thrombosis

Journal

Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334

Informations de publication

Date de publication:
25 Apr 2024
Historique:
received: 15 01 2024
accepted: 29 03 2024
medline: 25 4 2024
pubmed: 25 4 2024
entrez: 25 4 2024
Statut: aheadofprint

Résumé

Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by unregulated red blood cell production resulting in elevated hemoglobin and/or hematocrit levels. Patients often have symptoms such as fatigue, pruritus, and painful splenomegaly, but are also at risk of thrombosis, both venous and arterial. Ruxolitinib, a selective Janus kinase inhibitor, is approved by the US Food and Drug Administration as second-line cytoreductive treatment after intolerance or inadequate response to hydroxyurea. Although ruxolitinib has been widely used in this setting, limited data exist in the literature on ruxolitinib treatment patterns and outcomes among patients with PV in routine clinical practice. We report a retrospective, observational, cohort study of patients treated for PV with ruxolitinib across three US centers (academic and regional practice) from December 2014-December 2019. The study included 69 patients, with a median follow-up duration of 3.7 years (95% CI, 2.9-4.4). Our data demonstrate very high rates of hematocrit control (88% of patients by three months and 89% by six months); few patients required dose adjustments or suspension. No arterial thromboses were observed; however, the follow-up duration does not allow for the generation of meaningful conclusions from this. Three patients had thrombotic events; one was in the setting of a second malignancy, one post-operative, and a third related to prolonged immobility. We also found that 28% of patients initiated ruxolitinib as a result of poorly controlled platelet counts, second only to hydroxyurea intolerance (46%) as a reason to start therapy. In clinical practice, ruxolitinib continues to be effective in controlling hematocrit levels after three and six months of treatment in patients and is associated with low thrombotic risk.

Identifiants

pubmed: 38662203
doi: 10.1007/s00277-024-05735-7
pii: 10.1007/s00277-024-05735-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Aleksander Chojecki (A)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA. Aleksander.chojecki@atriumhealth.org.

Danielle Boselli (D)

Department of Biostatistics and Data Sciences, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Allison Dortilus (A)

Department of Biostatistics and Data Sciences, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Issam Hamadeh (I)

Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Stephanie Begley (S)

Department of Biostatistics and Data Sciences, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Tommy Chen (T)

Department of Biostatistics and Data Sciences, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Rupali Bose (R)

Department of Biostatistics and Data Sciences, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Nikolai Podoltsev (N)

Hematology Section, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.

Amer M Zeidan (AM)

Hematology Section, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.

Nicole Baranda Balmaceda (NB)

Department of Hematologic Malignancies and Cellular Therapies, Kansas University, Kansas City, KS, USA.

Abdulraheem Yacoub (A)

Department of Hematologic Malignancies and Cellular Therapies, Kansas University, Kansas City, KS, USA.

Jing Ai (J)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.

Thomas Gregory Knight (TG)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.

Brittany Knick Ragon (BK)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.

Nilay Arvind Shah (NA)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.

Srinivasa Reddy Sanikommu (SR)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.

James Symanowski (J)

Department of Biostatistics and Data Sciences, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.

Ruben Mesa (R)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.

Michael Richard Grunwald (MR)

Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute, Wake Forest University School of Medicine, Charlotte, NC, USA.

Classifications MeSH