Informace o publikaci

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

Autoři	OH Stephen T VERSTOVSEK Srdan GUPTA Vikas PLATZBECKER Uwe DEVOS Timothy KILADJIAN Jean-Jacques MCLORNAN Donal P PERKINS Andrew FOX Maria Laura MCMULLIN Mary Frances MEAD Adam J EGYED Miklos MAYER Jiří SACHA Tomasz KAWASHIMA Jun HUANG Mei STROUSE Bryan MESA Ruben
Rok publikování	2024
Druh	Článek v odborném periodiku
Časopis / Zdroj	eJHaem
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
www	https://onlinelibrary.wiley.com/doi/10.1002/jha2.854
Doi	http://dx.doi.org/10.1002/jha2.854
Klíčová slova	bone marrow fibrosis; JAK inhibitor; momelotinib; myelofibrosis; ruxolitinib
Popis	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.