Ruxolitinib Dosing for Anemic Myelofibrosis in an Older Patient

Dr. Bose discusses the potential adverse effects associated with ruxolitinib therapy and how they should be managed in this patient, with a focus on addressing the risk of anemia and other hematologic adverse effects.

Dr. Bose discusses the potential role of other treatment modalities, such as ruxolitinib combination therapies or novel agents, in managing this patient's myelofibrosis and anemia, including the emerging treatment options that may be relevant to this case.

Dr. Bose reviews the case of a 68-year-old woman with myelofibrosis presenting with mild fatigue, anemia, splenomegaly, and intermediate-2/high risk disease based on prognostic scoring systems.

Dr. Bose discusses the key diagnostic findings that support the diagnosis of myelofibrosis (MF) in this patient and reviews the treatment options and selection in accordance with the treatment guidelines for MF.

Dr. Bose explains the treatment goals for patients with MF, including the role of overall survival (OS) as a treatment goal.

Dr. Bose discusses the impact of ruxolitinib on the overall survival of patients with MF and briefly reviews the COMFORT I and COMFORT II trials that led to the approval of ruxolitinib.

Dr. Bose shares his experience in managing anemia in patients with myelofibrosis, including current strategies used in his practice and the effect of the degree of anemia on treatment approach.

Dr. Bose discusses the REALISE trial and its implications for ruxolitinib dosing strategy, particularly in terms of safety and efficacy, and the purpose of this dosing strategy assessment in this patient population.

Dr. Bose provides guidance on how he would approach ruxolitinib dosing if the patient's platelet count was 150 at week 12, including the potential use of the 5 mg tablet.