A recent study evaluated the impact of pretreatment with the JAK1/2 inhibitor ruxolitinib on outcomes after allogeneic hematopoietic cell transplantation (HSCT) in patients with myelofibrosis. The findings were published in Leukemia.
Researchers included 551 patients into this retrospective analysis: 274 who underwent HSCT without ruxolitinib pretreatment and 277 who underwent HSCT with ruxolitinib pretreatment.
On day 45, the overall leukocyte engraftment was 92%. Engraftment was significantly higher among patients whose disease responded to ruxolitinib, compared with those who had no response or lost response to ruxolitinib (94% vs. 85%; p=0.05).
In terms of post-transplant outcomes, the rate of one-year non-relapse mortality was 22%, without significant difference between the two treatment groups, the authors reported.
While ruxolitinib prior to HSCT did not negatively affect post-transplant outcomes, it was associated with better outcomes among patients with ongoing spleen response at time of transplantation, the authors noted. In a multivariable analysis, ruxolitinib-pretreated patients with ongoing spleen response at the time of HSCT had a significantly lower risk of relapse (8.1% vs. 19.1%; p=0.04), as well as higher rate of two-year event-free survival (68.9% vs. 53.7%; p=0.02).