J 2024

Changes in bone marrow fibrosis during momelotinib or ruxolitinib therapy do not correlate with efficacy outcomes in patients with myelofibrosis

OH, Stephen T, Srdan VERSTOVSEK, Vikas GUPTA, Uwe PLATZBECKER, Timothy DEVOS et. al.

Základní údaje

Originální název

Changes in bone marrow fibrosis during momelotinib or ruxolitinib therapy do not correlate with efficacy outcomes in patients with myelofibrosis

Autoři

OH, Stephen T, Srdan VERSTOVSEK, Vikas GUPTA, Uwe PLATZBECKER, Timothy DEVOS, Jean-Jacques KILADJIAN, Donal P MCLORNAN, Andrew PERKINS, Maria Laura FOX, Mary Frances MCMULLIN, Adam J MEAD, Miklos EGYED, Jiří MAYER (203 Česká republika, domácí), Tomasz SACHA, Jun KAWASHIMA, Mei HUANG, Bryan STROUSE a Ruben MESA

Vydání

eJHaem, Hoboken, Wiley, 2024, 2688-6146

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30205 Hematology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Organizační jednotka

Lékařská fakulta

UT WoS

001216592400041

Klíčová slova anglicky

bone marrow fibrosis; JAK inhibitor; momelotinib; myelofibrosis; ruxolitinib

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 19. 8. 2024 10:16, Mgr. Tereza Miškechová

Anotace

V originále

Bone marrow fibrosis (BMF) is a pathological feature of myelofibrosis, with higher grades associated with poor prognosis. Limited data exist on the association between outcomes and BMF changes. We present BMF data from Janus kinase (JAK) inhibitor-naive patients from SIMPLIFY-1 (NCT01969838), a double-blind, randomized, phase 3 study of momelotinib vs ruxolitinib. Baseline and week 24 bone marrow biopsies were graded from 0 to 3 as per World Health Organization criteria. Other assessments included Total Symptom Score, spleen volume, transfusion independence status, and hemoglobin levels. Paired samples were available from 144 and 160 patients randomized to momelotinib and ruxolitinib. With momelotinib and ruxolitinib, transfusion independence was achieved by 87% and 44% of patients with BMF improvement of >= 1 grade and 76% and 56% of those with stable/worsening BMF; there was no association between BMF changes and transfusion independence for either arm (momelotinib, p = .350; ruxolitinib, p = .096). Regardless of BMF changes, hemoglobin levels also generally increased on momelotinib but decreased on ruxolitinib. In addition, no associations between BMF changes and spleen (momelotinib, p = .126; ruxolitinib, p = .407)/symptom (momelotinib, p = .617; ruxolitinib, p = .833) outcomes were noted, and no improvement in overall survival was observed with >= 1-grade BMF improvement (momelotinib, p = .395; ruxolitinib, p = .407). These data suggest that the anemia benefit of momelotinib is not linked to BMF changes, and question the use of BMF assessment as a surrogate marker for clinical benefit with JAK inhibitors.