The MPN community is discussing the article by MPN researchers from MD Anderson – Clonal evolution and outcomes in myelofibrosis after ruxolitinib discontinuation – a retrospective study of 107 patients who discontinued ruxolitinib. The authors discussed the acquisition of additional mutations which took place in 35% of patients on Ruxolitinib, most notable the ASXL1 gene, which was found in 64% of patients who acquired new mutations.
We asked one of the authors – Dr. Serge Verstovsek – about what patients should take away from this article. He responded “While ruxolitinib in great majority of patients controls symptoms and signs of myelofibrosis very well, and with that may prolong life expectancy, it does not prevent a change in diseased cells, which can acquire new mutations or other characteristics that will make them resistant to ruxolitinib. This leads to a loss of a control and poor overall outcome. Therefore, one would like to encourage patient to consider a bone marrow transplant while doing well on ruxolitinib, to be potentially cured.”
This provides further motivation for studies that explore why people with ET or PV progress to MF and/or have a worsened prognosis, and how to stop that progression. It also supports the need for more therapy options for patients who can’t take Ruxolitinib, or who must stop taking it. We encourage you to share this with your doctors, nurses and care team.