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Myeloproliferative Neoplasms Case Studies

Case Studies: JAK Inhibition for the Management of Primary Myelofibrosis

Rami S. Komrokji, MD, explores the potential for treating a gentleman diagnosed with primary myelofibrosis with the JAK inhibitor ruxolitinib based on the man’s presentation and prognosis.

JAK Inhibition for the Management of Primary Myelofibrosis

Case: 66-Year-Old Man Diagnosed With Primary Myelofibrosis

January 2019

  • A 66-year old man presents to primary care physician with complaints of fatigue, headache, and abdominal discomfort when taking deep breaths
  • PMH: depression
  • PE: Splenomegaly ~7 cm below left costal margin
  • Lab values:
    • HGB: 9.2 g/dL
    • Platelets: 242 x 109/L
    • WBC: 26.2 x 109/L
    • Serum LDH: 1400 U/L
    • Serum EPO: 10.9 mU/mL
  • Bone Marrow Biopsy:
    • MF-3
    • Circulating blasts, 1.1%
    • JAK V617F mutation; trisomy 8
  • Peripheral Blood Smear: leukoerythroblastosis
  • Diagnosis:  Primary myelofibrosis
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