Onkológia 4/2022

Solving clinical problems in the treatment of myelofibrosis - how to prevent ruxolitinib failure

Treatment of myelofibrosis is a difficult process. Oftentimes even the correct diagnosis, correct stratification according to the newest prognosis models and treatment by roxolitinib does not guarantee the patient a prolonged survival. We are still left with relatively significant group of patients, in which the pharmacological therapy by ruxolitinib does not meet expectations. If the expected effect of ruxolitinib fails, it is observed that, the most common reasons are: underdosing of ruxolitinib, toxicity, incorrect interpretation of the undesirable effect with premature cancellation of treatment and the sole progression of the illness. Modifying the dosage, supportive therapy are in most cases helpful and allow for a continuation of the treatment. Transformation of myelofibrosis to an accelerated or blastic phases in a rare form of failure with an extremely poor prognosis and minimal possibilities of influencing an unfavourable development of MF.

Keywords: myelofibrosis, ruxolitinib, failure treatment, rechallenge