Vol 10, Supp. A (2019)
Case report
Published online: 2019-04-26
The problem of leukocytosis control in a patient with primary myelofibrosis treated with ruxolitinib
Abstract
Ruxolitynib — JAK1/JAK2 inhibitor — registrated for patients with myelofibrosis (MF) IPSS (International
Prognostic Scoring System) intermediate-2 or high, with splenomegaly and general symptomatology.
Moreover, ruxolitinib is used to reduce splenomegaly and general symptomatology in
patients with MF who are candidates for allogeneic hematopoietic stem cells transplantation (allo-
-HSCT). Anemia, thrombocytopenia and occasionally leukopenia with neutropenia are observed
as a main side effects of ruxolitinib. Moreover, there are problems related to cytokine storm caused
by treatment discontinuation. Here we report the patient with MF and important leucocytosis, in whom splenomegaly and general symptoms were reduced due to ruxolitinib. However, ruxolitinib
in monotherapy did not reduce the leukocyte count, so the the combined therapy with ruxolitinib
plus hydroxycarbamide was initiated. As the result of the treatment, reduction of number of leukocytes
was observed, meanwhile the level of hemoglobin was stable and platelets count drop slightly.
Thereafter, the patient proceeded to allo-HSCT. So far, there are two cases of patients treated with
ruxolitinib plus hydroxycarbamid published in the literature. We think, that all cases treated in that
way, should be reporteds, as we can establish the safety of this drug combination.
Keywords: mielofibrosisruxolitinibhydroxyurealeucocytosissafety