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Discussing Options for Ruxolitinib-Refractory Patients With Myelofibrosis

Robyn M. Scherber, MD, MPH
Published Online:5:17 PM, Thu May 30, 2019

Robyn M. Scherber, MD, MPH, a physician at Mays Cancer Center, UT Health San Antonio MD Anderson Cancer Center, discusses her advice for treating patients with myelofibrosis (MF) that become refractory or resistant to ruxolitinib (Jakifi).

Ruxolitinib should be maximized in patients with MF as it is known to have spleen response, symptom response, and patients also tend to feel better on it. Scherber says optimizing ruxolitinib is key. However, she has seen physicians try to dose down at the first sign of concerning anemia. Erythropoietin or danazol can be used to help treat anemia in these patients.

In addition, Scherber suggests physicians keep in mind that ruxolitinib can be combined with other agents with good efficacy. The most notable combination, ruxolitinib plus a hypomethylated agent, has demonstrated a response rate as high as over 70% in patients who are progressing toward blast phase.
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