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芦可替尼在初诊时合并贫血或血小板减少的骨髓纤维化患者中的真实世界应用

Real-World Use of Ruxolitinib in Patients with Myelofibrosis and Anemia or Thrombocytopenia at Diagnosis.

作者信息

Yu Jingbo, Bland Emily, Schuler Tammy, Cordaro Thomas, Braunstein Evan

机构信息

Incyte Corporation, Wilmington, Delaware, USA.

Cardinal Health, Dublin, Ohio, USA.

出版信息

Acta Haematol. 2024 Oct 21:1-11. doi: 10.1159/000541549.

Abstract

INTRODUCTION

Ruxolitinib is approved for treatment of myelofibrosis. We evaluated ruxolitinib in patients with anemia (hemoglobin <10 g/dL) or thrombocytopenia (platelet count ≤100 × 109/L) at diagnosis.

METHODS

This was a retrospective, secondary analysis of a Cardinal Health Oncology Provider Extended Network medical chart review of adults with myelofibrosis diagnosed between 2012 and 2016 who received first-line ruxolitinib.

RESULTS

176 patients received first-line ruxolitinib and were included in this analysis. At diagnosis, 120 patients had hemoglobin concentrations <10 g/dL and 59 had a platelet count ≤100 × 109/L. Most patients (95%) with thrombocytopenia also had anemia. Median time of observation after diagnosis was 21.4 months. Among patients with anemia or thrombocytopenia, ruxolitinib dose at end of study was ≥10 mg twice daily (bid) in 88.3% and 83.1%, respectively. Ruxolitinib treatment was ongoing in 76.1% of patients overall and was rarely discontinued for anemia or thrombocytopenia (n = 2 total, 1.1%). Per the treating physician, 79.7% of patients had improved symptoms and 62.7% improved spleen size.

CONCLUSION

Most patients with myelofibrosis and anemia or thrombocytopenia at diagnosis tolerated and maintained a ruxolitinib dose ≥10 mg bid for nearly 2 years, resulting in clinical benefit. This real-world evidence supports observations from prospective clinical trials of ruxolitinib in myelofibrosis.

摘要

引言

芦可替尼已被批准用于治疗骨髓纤维化。我们评估了芦可替尼在诊断时伴有贫血(血红蛋白<10 g/dL)或血小板减少(血小板计数≤100×10⁹/L)的患者中的应用情况。

方法

这是一项对2012年至2016年间诊断为骨髓纤维化并接受一线芦可替尼治疗的成年患者进行的回顾性二次分析,该分析基于红衣主教健康肿瘤医疗服务扩展网络的病历审查。

结果

176例患者接受了一线芦可替尼治疗并纳入本分析。诊断时,120例患者血红蛋白浓度<10 g/dL,59例患者血小板计数≤100×10⁹/L。大多数血小板减少的患者(95%)也伴有贫血。诊断后的中位观察时间为21.4个月。在贫血或血小板减少的患者中,研究结束时芦可替尼剂量≥10 mg每日两次(bid)的患者分别占88.3%和83.1%。总体上,76.1%的患者仍在接受芦可替尼治疗,很少因贫血或血小板减少而停药(共2例,1.1%)。据主治医生判断,79.7%的患者症状有所改善,62.7%的患者脾脏大小有所缩小。

结论

大多数诊断时伴有贫血或血小板减少的骨髓纤维化患者耐受并维持芦可替尼剂量≥10 mg bid近2年,从而获得临床益处。这一真实世界证据支持了芦可替尼治疗骨髓纤维化的前瞻性临床试验的观察结果。

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