Dr. Snyder on Ruxolitinib in Patients With Myelofibrosis

David S. Snyder, MD, associate chair and professor, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, discusses the use of ruxolitinib (Jakafi) in myelofibrosis.

Ruxolitinib is very good at shrinking spleen size and controlling constitutional symptoms, which are very important sources of clinical problems for patients. It is part of the reason why patients lose weight, have decreased muscle mass, and poor performance status, says Snyder. If physicians can significantly reduce the spleen size and improve their patient's ability to eat, that can help performance status. Reducing some of the constitutional symptoms also improves a patients' quality of life.

The use of ruxolitinib does however lower platelet count. Physicians must be careful about that and adjust the dose appropriately, Snyder says. It may worsen anemia, at least initially, which is a problem that most patients are dealing with already. For most patients, if their hemoglobin drops, it will recover to baseline after a few months. That effect does not seem to impair or impact the ultimate benefits to the drug, says Snyder.