March 22, 2018

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.