Survival and quality‐of‐life implications of cytopenia trajectories in ruxolitinib‐treated myelofibrosis
Year: 2026
Type: article
Abstract: BACKGROUND: Cytopenia is a common complication in patients with myelofibrosis and may worsen during treatment with ruxolitinib. METHODS: The RUX-MF multicenter study evaluated 879 patients treated with ruxolitinib for at least 6 months, categorizing them into four groups based on the evolution of cytopenia: never cytopenic, treatment-emergent cytopenia, persistent cytopenia, and improved anemia. RESULTS: At baseline, 40.6% of patients presented with cytopenia, increasing to 57.8% after 6 months. Baseline cytopenia was associated with significantly reduced median overall survival (OS) compared to noncytopenic patients (3.7 vs. 6.7 years). Prognosis varied notably across groups: patients who remained noncytopenic had the median best OS (8.1 years), whereas those with persistent cytopenia had the worst (3.7 years). Treatment-emergent cytopenia was linked to intermediate outcomes (5.1 years), with isolated thrombocytopenia showing the poorest prognosis (4.3 years) and anemia a slightly better one (6.1 years). Patients with improved anemia had better survival than those with persistent anemia (5.2 vs. 3.5 years). Symptom response mirrored survival trends, with the best outcomes in noncytopenic and improved anemia groups. CONCLUSIONS: These findings highlight the prognostic significance of cytopenia dynamics during ruxolitinib therapy and support the use of cytopenia trajectory monitoring as a valuable tool for risk stratification and treatment optimization in myelofibrosis.
Source: Cancer
DOI: 10.1002/cncr.70320
Authors: Francesca Palandri, Giovanni Caocci, Elisabetta Abruzzese, Mario Tiribelli, Erika Morsia, Mirko Farina, Giulia Benevolo, Eloise Beggiato, Bruno Martino, Novella Pugliese, Alessia Tieghi, Monica Crugnola, Gianni Binotto, Francesco Cavazzini, Alessandra Iurlo, Alessandro Isidori, Alessandra Dedola, Emilia Scalzulli, Andrea Duminuco, Daniele Cattaneo, Roberto M. Lemoli, Costanza Bosi, Daniela Cilloni, Monica Bocchia, Fabrizio Pane, Chiara Sartor, Florian H. Heidel, Massimo Breccia, Filippo Branzanti, Giuseppe A. Palumbo, Massimiliano Bonifacio, Elena M. Elli
Institutions: Istituto di Ematologia di Bologna, University of Cagliari, St. Eugenio Hospital, University of Udine, Marche Polytechnic University, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Azienda ospedaliera "Bianchi-Melacrino-Morelli", Federico II University Hospital, University of Naples Federico II, Azienda Sanitaria Unità Locale di Reggio Emilia, University of Parma, University of Padua, University of Ferrara, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Ospedali Riuniti Marche Nord, University of Bologna, Policlinico Umberto I, Sapienza University of Rome, Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco", Ospedale Policlinico San Martino, University of Genoa, Azienda Unità Sanitaria Locale Piacenza, University of Siena, Azienda Ospedaliera Universitaria Senese, Medizinische Hochschule Hannover, University of Catania, University of Verona
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
Funder: Ministero della Salute
Award: G5095041797
OpenAlex ID: W7128779914