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).