Decitabine Plus Ruxolitinib Demonstrates Clinical Benefit in Patients with MPN

Decitabine with or without ruxolitinib is beneficial for patients with advanced myeloproliferative neoplasms (MPN) when initiated early in the disease course prior to the development of MPN blast-phase (BP) disease, according to a study published in Acta Haematologica. 

The retrospective study included 42 patients treated with decitabine alone or in combination with ruxolitinib; 16 patients had with MPN-BP, 14 had MPN accelerated-phase (MPN-AP), and 12 had myelofibrosis with high-risk features (MF-HR).

Median overall survival (OS) for patients with MPN-BP was 2.6 months, and for those who received two or more cycles of decitabine therapy, it was 6.7 months (95% confidence interval, 3.8-29.8). Patients with MPN-BP with a poor performance status and who required hospitalization at the time of the initiation of decitabine had a poor prognosis.

After a median follow-up of 12.4 months for patients with MPN-AP and 38.7 months for patients with MF-HR, median OS was not reached for either cohort; at 60 months, one and two patients, respectively, were alive.

The probability of spleen length reduction and transfusion independence within 12 months of initiating decitabine was 28.6% and 23.5%, respectively. The combination of decitabine and ruxolitinib improved OS (21.0 months) compared with single-agent decitabine (12.9 months).