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Ruksolitinib Klinik ve Mikrobiyolojik İçerikleri ve B Hücreli Lenfoma ile Olası İlişkisi

Year 2020, Volume: 3 Issue: 3, 134 - 141, 31.12.2020

Müfide Okay Arzu Sağlam Ümit Yavuz Malkan Yahya Büyükaşık Salih Aksu Nilgün Sayınalp İbrahim Celalettin Haznedaroğlu

Abstract

Introduction
Ruxolitinib is a Janus kinase (JAK)1/JAK2 inhibitor for the treatment with primary myelofibrosis (PMF), post–polycythemia MF (PPVMF), and post–essential thrombocythemia MF (PETMF) for diseaserelated splenomegaly or symptoms in adult patients. Ruxolitinib is effective treatment choice for myelofibrosis. But ruxolitinib has some adverse event, hematologic and nonhematologic. In this study, we wanted to present the results of our patients using ruxolitinib.
Materials and Methods
Total 40 patients data were retrospectively analyzed. Categorical and continuous data were expressed as ratio (%) and median (range). Overall survival (OS) is taken as end-points of this study.
Results
The total number of patients was 40. 4 patient received ruxolitinib for cGVHD after allogeneic stem cell tranplantation. The total number of patients who analyzed was 28. The median age of patients was 54 years (35-78). Median ruxolitinib treatment duration was 383 days (37-1596 days). After ruxolitinib, median platelet, hemoglobin, neutrophil nadir durations were 46 days (0-546), 40 days (14-218days) and 112 days (16-546days), respectively. The median nadir hemoglobin and platelet level were 8.3 g/dl (5 g/dl -15 g/dl) and 147.5103/µl (29103/µl -589103/µl), respectively. The median follow up was 1291 days (40 -8053 days). The 5-year OS rate was 60.6% and 90% in hemoglobine and platelet recovery time <100days and ≥100 days (p=0.9). 7 patients were died, one of them had oppurtunistic fungal infection.
Conclusion
In conclusion, although ruxolitinib has been shown to improve survival in myelofibrosis in the long term, survival may be short due to side effects.

Keywords

ruksolinitib yan etkiler myelofibrozis

Supporting Institution

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Thanks

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References

  • [1] Verstovsek S, Gotlib J, Mesa RA, Vannucchi AM, Kiladjian J-J, Cervantes F, et al. Long-term survival in patients treated with ruxolitinib for myelofibrosis: COMFORT-I and-II pooled analyses. Journal of hematology & oncology 2017;10:1156.
  • [2] Palandri F, Palumbo GA, Iurlo A, Polverelli N, Benevolo G, Breccia M, et al. Differences in presenting features, outcome and prognostic models in patients with primary myelofibrosis and post-polycythemia vera and/or post-essential thrombocythemia myelofibrosis treated with ruxolitinib. New perspective of the MYSEC-PM in a large multicenter study(). Semin Hematol 2018;55:4248-55.
  • [3] Cervantes F, Dupriez B, Pereira A, Passamonti F, Reilly JT, Morra E, et al. New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood 2009;113:132895-901.
  • [4] Passamonti F, Cervantes F, Vannucchi AM, Morra E, Rumi E, Cazzola M, et al. Dynamic International Prognostic Scoring System (DIPSS) predicts progression to acute myeloid leukemia in primary myelofibrosis. Blood 2010;116:152857-8.
  • [5] Gangat N, Caramazza D, Vaidya R, George G, Begna K, Schwager S, et al. DIPSS plus: a refined Dynamic International Prognostic Scoring System for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count, and transfusion status. Journal of Clinical Oncology 2010;29:4392-7.
  • [6] Verstovsek S, Mesa RA, Gotlib J, Levy RS, Gupta V, DiPersio JF, et al. A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis. New England Journal of Medicine 2012;366:9799-807.
  • [7] Verstovsek S, Mesa RA, Gotlib J, Gupta V, DiPersio JF, Catalano JV, et al. Long-term treatment with ruxolitinib for patients with myelofibrosis: 5-year update from the randomized, double-blind, placebo-controlled, phase 3 COMFORT-I trial. Journal of hematology & oncology 2017;10:155.
  • [8] Porpaczy E, Tripolt S, Hoelbl-Kovacic A, Gisslinger B, Bago-Horvath Z, Casanova-Hevia E, et al. Aggressive B-cell lymphomas in patients with myelofibrosis receiving JAK1/2 inhibitor therapy. Blood 2018:blood-2017-10-810739.
  • [9] Bhatt VR, Bociek RG, Yuan J, Fu K, Greiner TC, Dave BJ, et al. Leukemic diffuse large B-cell lymphoma in a patient with myeloproliferative disorder. Journal of the National Comprehensive Cancer Network 2015;13:3281-7.
  • [10] Tefferi A, Pardanani A, editors. Serious adverse events during ruxolitinib treatment discontinuation in patients with myelofibrosis. Mayo Clinic Proceedings; 2011: Elsevier.
  • [11] Modi B, Hernandez-Henderson M, Yang D, Klein J, Dadwal S, Kopp E, et al. Ruxolitinib as Salvage Therapy for Chronic Graft-versus-Host Disease. Biology of Blood and Marrow Transplantation 2018.
  • [12] Malkan UY, Haznedaroglu IC. Case Report A myelofibrosis case that develops mycobacterial infection after ruxolitinib treatment. Int J Clin Exp Med 2017;10:47304-7.
  • [13] Palandri F, Palumbo GA, Bonifacio M, Breccia M, Latagliata R, Martino B, et al. Durability of spleen response affects the outcome of ruxolitinib-treated patients with myelofibrosis: Results from a multicentre study on 284 patients. Leukemia research 2018;74:86-8.
  • [14] Lescuyer S, Ledoux MP, Gravier S, Natarajan-Ame S, Duval C, Maloisel F, et al. Tuberculosis and atypical mycobacterial infections in ruxolitinib treated patients with primary or secondary myelofibrosis or polycythemia vera. Int J Infect Dis 2019.
  • [15] Tefferi A, Vardiman J. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. Leukemia 2008;22:114.

Ruxolitinib Clinical and Microbiological Implications and Possible Association with B Cell Lymphoma

Year 2020, Volume: 3 Issue: 3, 134 - 141, 31.12.2020

Müfide Okay Arzu Sağlam Ümit Yavuz Malkan Yahya Büyükaşık Salih Aksu Nilgün Sayınalp İbrahim Celalettin Haznedaroğlu

Abstract

ABSTRACT
Introduction
Ruxolitinib is a Janus kinase (JAK)1/JAK2 inhibitor for the treatment with primary myelofibrosis (PMF), post–polycythemia MF (PPVMF), and post–essential thrombocythemia MF (PETMF) for diseaserelated splenomegaly or symptoms in adult patients. Ruxolitinib is effective treatment choice for myelofibrosis. But ruxolitinib has some adverse event, hematologic and nonhematologic. In this study, we wanted to present the results of our patients using ruxolitinib.
Materials and Methods
Total 40 patients data were retrospectively analyzed. Categorical and continuous data were expressed as ratio (%) and median (range). Overall survival (OS) is taken as end-points of this study.
Results
The total number of patients was 40. 4 patient received ruxolitinib for cGVHD after allogeneic stem cell tranplantation. The total number of patients who analyzed was 28. The median age of patients was 54 years (35-78). Median ruxolitinib treatment duration was 383 days (37-1596 days). After ruxolitinib, median platelet, hemoglobin, neutrophil nadir durations were 46 days (0-546), 40 days (14-218days) and 112 days (16-546days), respectively. The median nadir hemoglobin and platelet level were 8.3 g/dl (5 g/dl -15 g/dl) and 147.5103/µl (29103/µl -589103/µl), respectively. The median follow up was 1291 days (40 -8053 days). The 5-year OS rate was 60.6% and 90% in hemoglobine and platelet recovery time <100days and ≥100 days (p=0.9). 7 patients were died, one of them had oppurtunistic fungal infection.
Conclusion
In conclusion, although ruxolitinib has been shown to improve survival in myelofibrosis in the long term, survival may be short due to side effects.

Keywords

ruxolitinib adverse events myelofibrosis

References

  • [1] Verstovsek S, Gotlib J, Mesa RA, Vannucchi AM, Kiladjian J-J, Cervantes F, et al. Long-term survival in patients treated with ruxolitinib for myelofibrosis: COMFORT-I and-II pooled analyses. Journal of hematology & oncology 2017;10:1156.
  • [2] Palandri F, Palumbo GA, Iurlo A, Polverelli N, Benevolo G, Breccia M, et al. Differences in presenting features, outcome and prognostic models in patients with primary myelofibrosis and post-polycythemia vera and/or post-essential thrombocythemia myelofibrosis treated with ruxolitinib. New perspective of the MYSEC-PM in a large multicenter study(). Semin Hematol 2018;55:4248-55.
  • [3] Cervantes F, Dupriez B, Pereira A, Passamonti F, Reilly JT, Morra E, et al. New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood 2009;113:132895-901.
  • [4] Passamonti F, Cervantes F, Vannucchi AM, Morra E, Rumi E, Cazzola M, et al. Dynamic International Prognostic Scoring System (DIPSS) predicts progression to acute myeloid leukemia in primary myelofibrosis. Blood 2010;116:152857-8.
  • [5] Gangat N, Caramazza D, Vaidya R, George G, Begna K, Schwager S, et al. DIPSS plus: a refined Dynamic International Prognostic Scoring System for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count, and transfusion status. Journal of Clinical Oncology 2010;29:4392-7.
  • [6] Verstovsek S, Mesa RA, Gotlib J, Levy RS, Gupta V, DiPersio JF, et al. A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis. New England Journal of Medicine 2012;366:9799-807.
  • [7] Verstovsek S, Mesa RA, Gotlib J, Gupta V, DiPersio JF, Catalano JV, et al. Long-term treatment with ruxolitinib for patients with myelofibrosis: 5-year update from the randomized, double-blind, placebo-controlled, phase 3 COMFORT-I trial. Journal of hematology & oncology 2017;10:155.
  • [8] Porpaczy E, Tripolt S, Hoelbl-Kovacic A, Gisslinger B, Bago-Horvath Z, Casanova-Hevia E, et al. Aggressive B-cell lymphomas in patients with myelofibrosis receiving JAK1/2 inhibitor therapy. Blood 2018:blood-2017-10-810739.
  • [9] Bhatt VR, Bociek RG, Yuan J, Fu K, Greiner TC, Dave BJ, et al. Leukemic diffuse large B-cell lymphoma in a patient with myeloproliferative disorder. Journal of the National Comprehensive Cancer Network 2015;13:3281-7.
  • [10] Tefferi A, Pardanani A, editors. Serious adverse events during ruxolitinib treatment discontinuation in patients with myelofibrosis. Mayo Clinic Proceedings; 2011: Elsevier.
  • [11] Modi B, Hernandez-Henderson M, Yang D, Klein J, Dadwal S, Kopp E, et al. Ruxolitinib as Salvage Therapy for Chronic Graft-versus-Host Disease. Biology of Blood and Marrow Transplantation 2018.
  • [12] Malkan UY, Haznedaroglu IC. Case Report A myelofibrosis case that develops mycobacterial infection after ruxolitinib treatment. Int J Clin Exp Med 2017;10:47304-7.
  • [13] Palandri F, Palumbo GA, Bonifacio M, Breccia M, Latagliata R, Martino B, et al. Durability of spleen response affects the outcome of ruxolitinib-treated patients with myelofibrosis: Results from a multicentre study on 284 patients. Leukemia research 2018;74:86-8.
  • [14] Lescuyer S, Ledoux MP, Gravier S, Natarajan-Ame S, Duval C, Maloisel F, et al. Tuberculosis and atypical mycobacterial infections in ruxolitinib treated patients with primary or secondary myelofibrosis or polycythemia vera. Int J Infect Dis 2019.
  • [15] Tefferi A, Vardiman J. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. Leukemia 2008;22:114.
There are 15 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Articles
Authors

Müfide Okay 0000-0001-5317-0597

Arzu Sağlam 0000-0002-0076-8293

Ümit Yavuz Malkan This is me 0000-0001-5444-4895

Yahya Büyükaşık This is me 0000-0002-2700-295X

Salih Aksu This is me 0000-0002-1144-2520

Nilgün Sayınalp This is me 0000-0002-4782-896X

İbrahim Celalettin Haznedaroğlu This is me 0000-0001-8028-9462

Publication Date December 31, 2020
Acceptance Date October 15, 2020
Published in Issue Year 2020 Volume: 3 Issue: 3

Cite

APA Okay, M., Sağlam, A., Malkan, Ü. Y., Büyükaşık, Y., et al. (2020). Ruxolitinib Clinical and Microbiological Implications and Possible Association with B Cell Lymphoma. Journal of Cukurova Anesthesia and Surgical Sciences, 3(3), 134-141.
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