期刊
ONCOTARGET
卷 8, 期 45, 页码 79073-79086出版社
IMPACT JOURNALS LLC
DOI: 10.18632/oncotarget.18674
关键词
myelofibrosis; splenomegaly; response; ruxolitinib; predictive factors
资金
- BolognAIL
- Bologna University (RFO)
In patients with Myelofibrosis (MF) treated with ruxolitinib (RUX), the response is unpredictable at therapy start. We retrospectively evaluated the impact of clinical/laboratory factors on responses in 408 patients treated with RUX according to prescribing obligations in 18 Italian Hematology Centers. At 6 months, 114 out of 327 (34.9%) evaluable patients achieved a spleen response. By multivariable Cox proportional hazard regression model, pre-treatment factors negatively correlating with spleen response were: high/intermediate-2 IPSS risk (p= 0.024), large splenomegaly (p= 0.017), transfusion dependency (p= 0.022), platelet count < 200x10(9)/l (p= 0.028), and a time-interval between MF diagnosis and RUX start > 2 years (p= 0.048). Also, patients treated with higher (>= 10 mg BID) average RUX doses in the first 12 weeks achieved higher response rates (p= 0.019). After adjustment for IPSS risk, patients in spleen response at 6 months showed only a trend for better survival compared to non-responders. At 6 months, symptoms response was achieved by 85.5% of 344 evaluable patients; only a higher (> 20) Total Symptom Score significantly correlated with lower probability of response (p<0.001). Increased disease severity, a delay in RUX start and titrated doses < 10 mg BID were associated with patients achievinglower response rates. An early treatment and higher RUX doses may achieve better therapeutic results.
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