The Use of Ruxolitinib as Peri-Transplant Treatment for Myelofibrosis

Haris Ali, MD, discusses the use of ruxolitinib as peri-transplant treatment for patients with myelofibrosis.

Haris Ali, MD, a hematology oncologist at the City of Hope Comprehensive Cancer Center, discusses the use of ruxolitinib (Jakafi) as peri-transplant treatment for patients with myelofibrosis.

According to Ali, the only approved treatment for myelofibrosis are the JAK inhibitors ruxolitinib and fedratinib (Inrebic). When patients progressed to the point where a transplant was needed, ruxolitinib was generally stopped. However, according to Ali, this abrupt stop was associated with ruxolitinib withdrawal syndrome.

Ruxolitinib withdrawal syndrome is a serious adverse event that manifests as circulatory shock. During ruxolitinib withdrawal syndrome, a patient can go into renal failure. According to Ali, the purpose of continuing ruxolitinib was not only to prevent withdrawal syndrome, but to also add to the beneficial effects of ruxolitinib during transplant. This may potentially decrease the risk of graft versus host disease and improve engraftment after transplant.