Ruxolitinib in MF with anemia: Real-world treatment patterns and survival outcomes

Results from a retrospective, real-world analysis of the US Flatiron Health electronic health record-derived deidentified database, evaluating baseline patient characteristics, treatment patterns, and survival outcomes with ruxolitinib in adults with myelofibrosis (MF) with (n = 175) or without (n = 208) baseline anemia, were published in Leukemia & Lymphoma by Kuykendall et al.  

Key data: Baseline anemic vs nonanemic patients demonstrated a trend toward starting ruxolitinib at 5 mg twice daily (31% vs 15%) and remaining on <20 mg/day throughout the first 3 months (25% vs 16%; p = 0.09), with a numerically shorter median time to first dose reduction (5.6 vs 12.8 months; p = 0.46) and discontinuation (16.7 vs 24.8 months; p = 0.26). Median overall survival (OS) was shorter with baseline anemia (37.4 vs 64.9 months; p < 0.001), with ruxolitinib <20 vs ≥20 mg/day during the first 3 months (40.1 vs 53.1 months; p < 0.05), and with new/worsening anemia on treatment, in all patients regardless of baseline anemia status (hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.18–2.40; p < 0.01). 

Key learning: These real-world data suggest that both baseline and on-treatment anemia are associated with lower ruxolitinib dose intensity and poorer survival in MF, supporting consideration of alternative therapies when anemia limits maintenance of effective ruxolitinib dosing.