Treatment Sequencing in Myelofibrosis


Dr Oh provides clinical insights on sequencing therapies for patients with myelofibrosis and discusses the sequential use of JAK inhibitors.

Case: A 63-Year-Old Man with Myelofibrosis

Clinical Presentation:

  • A 63-year-old man recently diagnosed with primary MF and initiated on 10 mg BID ruxolitinib.
  • PMH: type 2 diabetes, hypercholesteremia, and hypertension, squamous cell carcinoma (SCC)

Follow up and Clinical Workup at 3 Months:

  • Exam: night sweats improved.
  • Labs: Hb 7.8 g/dL; Plt 80 x 109/L (previously 135k) stabilized.
  • Some spleen reduction.
  • Patient receives ~1 unit RBC per month.

Follow up and Clinical Workup at 6 Months:

  • Patient reports complaints of fatigue and abdominal pain.
  • Labs: Plt 55 x 109/L; Hgb 6.8 g/dL
  • Patient now receives 2 units RBC per month.
  • Experienced recurrence of SCC.
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