Key Findings from COMFORT I and II Trials

Opinion
Video

Dr. Bose discusses the key findings from the COMFORT I and II trials and how the overall survival data has impacted the way he manages patients with myelofibrosis, along with the factors that most inform his treatment decisions.

Case: Intermediate-Risk Primary Myelofibrosis in a 68-Year-Old Woman

Clinical Presentation:

  • A 68-year-old woman presented to her physician with symptoms of mild fatigue.
  • Spleen was palpable 6-7 cm below the left costal margin.

PM: No known comorbidities

Initial Clinical Workup and Diagnosis:

  • NGS Testing: JAK2 V617F mutation
  • Karyotype: 46XX
  • BM biopsy: megakaryocyte proliferation and atypia with evidence of reticulin fibrosis
  • Blood smear: leukoerythroblastosis
  • Diagnosis: Primary myelofibrosis
  • Risk:
    • DIPSS: Intermediate-2
    • Mipss70: Intermediate risk
  • Lab Values
    • RBC 3.40 x 1012/L
    • Hgb 9.7 g/dL
    • HCT 32.3%
    • MCV 94 fL
    • WBC 23.0 x 109/L
    • PLT 450 x 109/L
    • PB Blasts <1%

Initial Treatments:

  • Initiated on ruxolitinib.
    • The patient was not interested in transplant.
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