Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

MF Treatment Pre- and Post Ruxolitinib Approval

Clin Lymphoma Myeloma Leuk; 2017 Aug 4; Kuykendall, et al

Increased use of ruxolitinib in patients with myelofibrosis appears to be occurring mostly at the expense of thalidomide and erythropoiesis-stimulating agents (ESAs), according to a retrospective analysis involving 309 individuals. It has not had a major effect on first-line use of hydroxyurea. Participants had myelofibrosis and were treated at a single center either before (n=174) or after (n=135) ruxolitinib’s approval. Among the results:

  • Patients treated after ruxolitinib’s approval were less likely to receive ESAs and thalidomide than those treated before approval.
  • In patients with myelofibrosis-related symptoms and/or splenomegaly, increased ruxolitinib use was linked with decreased first-line ESA or thalidomide use.
  • Increased use of first-line ruxolitinib was linked with decreased thalidomide use in patients with anemia.
  • Hydroxyurea was the preferred first-line treatment in those with severe leukocytosis.


Kuykendall A, Talati C, Najla A, et al. The treatment landscape of myelofibrosis before and after ruxolitinib approval. [Published online ahead of print August 4, 2017]. Clin Lymphoma Myeloma Leuk. doi:10.1016/j.clml.2017.08.002.