Balancing Toxicity Concerns with Achieving Adequate Response in Myelofibrosis
An overview of how toxicity concerns are balanced with the goal of achieving adequate response in patients with myelofibrosis who receive sequential therapies such as 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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