Lower platelet count a predictor for ruxolitinib-induced thrombocytopenia
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SAN DIEGO — Lower platelet count was identified as a significant predictor for ruxolitinib-induced moderate or severe thrombocytopenia in patients with myelofibrosis, according to research presented at ASH Annual Meeting and Exposition.
The data could “guide the preferential use of alternative JAK inhibitors” in patients who present this risk, according to a team led by Douglas Tremblay, MD, an assistant professor of medicine at Icahn School of Medicine at Mount Sinai.
Thrombocytopenia has often arisen as a complicating factor in ruxolitinib (Jakafi, Incyte) treatment of myelofibrosis, which ultimately can lead to poor outcomes stemming from ruxolitinib discontinuation or dose reduction.
With the recent development and approval of other JAK inhibitors that are effective in patients with thrombocytopenic myelofibrosis, the study aimed to provide guidance towards “personalized JAK inhibitor selection in the upfront setting,” the researchers wrote.
Tremblay’s team conducted a retrospective cohort study of JAK inhibitor-naive myelofibrosis patients treated with ruxolitinib at Mount Sinai and Moffitt Cancer Center — the primary endpoint was a platelet count of < 100 x 109/L by 3 months, in order to differentiate ruxolitinib-induced thrombocytopenia as opposed to typical disease progression.
Out of 246 patients who were identified with the baseline characteristics, 15% reached the primary endpoint by 3 months, and the highest rate of thrombocytopenia was found in patients with a 100-150 platelet count x 109/L, with 151-200 x 109/L also retaining significance.
According to Tremblay, the data did not indicate that ruxolitinib dose predicted the development of thrombocytopenia, nor did baseline mutational profile.
Reference:
- Tremblay D, et al. Prevalence and prediction of ruxolitinib treatment emergent thrombocytopenia in myelofibrosis. Presented at: ASH Annual Meeting and Exposition; Dec. 9-12, 2023; San Diego.
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