TY - JOUR
T1 - Baseline factors associated with response to ruxolitinib
T2 - An independent study on 408 patients with myelofibrosis
AU - Palandri, Francesca
AU - Palumbo, Giuseppe Alberto
AU - Bonifacio, Massimiliano
AU - Tiribelli, Mario
AU - Benevolo, Giulia
AU - Martino, Bruno
AU - Abruzzese, Elisabetta
AU - D'Adda, Mariella
AU - Polverelli, Nicola
AU - Bergamaschi, Micaela
AU - Tieghi, Alessia
AU - Cavazzini, Francesco
AU - Ibatici, Adalberto
AU - Crugnola, Monica
AU - Bosi, Costanza
AU - Latagliata, Roberto
AU - Di Veroli, Ambra
AU - Scaffidi, Luigi
AU - de Marchi, Federico
AU - Cerqui, Elisa
AU - Anaclerico, Barbara
AU - De Matteis, Giovanna
AU - Spinsanti, Marco
AU - Sabattini, Elena
AU - Catani, Lucia
AU - Aversa, Franco
AU - Di Raimondo, Francesco
AU - Vitolo, Umberto
AU - Lemoli, Roberto Massimo
AU - Fanin, Renato
AU - Merli, Francesco
AU - Russo, Domenico
AU - Cuneo, Antonio
AU - Reggiani, Maria Letizia Bacchi
AU - Cavo, Michele
AU - Vianelli, Nicola
AU - Breccia, Massimo
PY - 2017
Y1 - 2017
N2 - In patients with Myelofibrosis (MF) treated with ruxolitinib (RUX), the response is unpredictable at therapy start. We retrospectively evaluated the impact of clinical/laboratory factors on responses in 408 patients treated with RUX according to prescribing obligations in 18 Italian Hematology Centers. At 6 months, 114 out of 327 (34.9%) evaluable patients achieved a spleen response. By multivariable Cox proportional hazard regression model, pre-treatment factors negatively correlating with spleen response were: high/intermediate-2 IPSS risk (p=0.024), large splenomegaly (p=0.017), transfusion dependency (p=0.022), platelet count < 200x109/l (p=0.028), and a time-interval between MF diagnosis and RUX start > 2 years (p=0.048). Also, patients treated with higher (≥10 mg BID) average RUX doses in the first 12 weeks achieved higher response rates (p=0.019). After adjustment for IPSS risk, patients in spleen response at 6 months showed only a trend for better survival compared to non-responders. At 6 months, symptoms response was achieved by 85.5% of 344 evaluable patients; only a higher (> 20) Total Symptom Score significantly correlated with lower probability of response (p < 0.001). Increased disease severity, a delay in RUX start and titrated doses < 10 mg BID were associated with patients achievinglower response rates. An early treatment and higher RUX doses may achieve better therapeutic results.
AB - In patients with Myelofibrosis (MF) treated with ruxolitinib (RUX), the response is unpredictable at therapy start. We retrospectively evaluated the impact of clinical/laboratory factors on responses in 408 patients treated with RUX according to prescribing obligations in 18 Italian Hematology Centers. At 6 months, 114 out of 327 (34.9%) evaluable patients achieved a spleen response. By multivariable Cox proportional hazard regression model, pre-treatment factors negatively correlating with spleen response were: high/intermediate-2 IPSS risk (p=0.024), large splenomegaly (p=0.017), transfusion dependency (p=0.022), platelet count < 200x109/l (p=0.028), and a time-interval between MF diagnosis and RUX start > 2 years (p=0.048). Also, patients treated with higher (≥10 mg BID) average RUX doses in the first 12 weeks achieved higher response rates (p=0.019). After adjustment for IPSS risk, patients in spleen response at 6 months showed only a trend for better survival compared to non-responders. At 6 months, symptoms response was achieved by 85.5% of 344 evaluable patients; only a higher (> 20) Total Symptom Score significantly correlated with lower probability of response (p < 0.001). Increased disease severity, a delay in RUX start and titrated doses < 10 mg BID were associated with patients achievinglower response rates. An early treatment and higher RUX doses may achieve better therapeutic results.
KW - Myelofibrosis
KW - Predictive factors
KW - Response
KW - Ruxolitinib
KW - Splenomegaly
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U2 - 10.18632/oncotarget.18674
DO - 10.18632/oncotarget.18674
M3 - Article
AN - SCOPUS:85030457151
VL - 8
SP - 79073
EP - 79086
JO - Oncotarget
JF - Oncotarget
SN - 1949-2553
IS - 45
ER -