Ruxolitinib Therapy for Myelofibrosis Demonstrates Comparable Efficacy and Safety Among All Patient Age Groups
Among patients with myelofibrosis treated with ruxolitinib, the therapeutic efficacy and safety of ruxolitinib therapy was shown to be consistent among all patients regardless of age, while clinical features and mutation profiles varied significantly across age groups, according to study results published in the Chinese Journal of Hematology.
Researchers conducted a retrospective study to determine the efficacy and safety of ruxolitinib among patients with myelofibrosis stratified by age. Patients were stratified into 3 age groups including middle-aged (≤ 55 years), young elderly (56 to 65 years), and elderly (> 65 years).
Prior to treatment, the elderly group demonstrated a greater burden of comorbidities, higher symptom severity, elevated leukocyte counts, and higher frequency of JAK2 mutations, alongside a lower incidence of CALR mutations, while the young elderly group had a higher prevalence of nondriver gene mutations.
Following ruxolitinib initiation, spleen volume reduction which was defined as ≥ 50% reduction in palpable spleen length, was achieved in 50.9% of patients in the middle-aged group, 43.5% of patients in the young elderly group, and 45.5% of patients in the elderly group (P = 0.720). Symptom improvement, assessed using the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF TSS), demonstrated a ≥ 50% score reduction among 54.0% of patients in the middle-aged group, 60.3% of patients in the young elderly group, and 66.7% of patients in the elderly group (P = 0.429).
The most frequently observed adverse events were anemia, thrombocytopenia, electrolyte disturbances, elevated liver enzymes, and pulmonary infections and adverse event profiles were comparable across all age groups.
Multivariate Cox regression identified several independent predictors of poor overall survival in ruxolitinib-treated patients which include increasing age, low hemoglobin levels, bone marrow blasts ≥1%, absence of JAK2 mutations, chromosomal abnormalities, 2 high-molecular-risk mutations or more, and TP53 mutations.
The researchers concluded, “Patients with myelofibrosis stratified by age exhibited heterogeneous clinical features and gene mutation profiles but similar efficacy of ruxolitinib treatment and occurrence of adverse events.”
Source:
Liu XH, Yu Y, Yan FM, et al. Efficacy of ruxolitinib and prognostic factors in patients with myelofibrosis stratified by age. Chinese Journal of Hematology. Published online August 14, 2025. doi:10.3760/cma.j.cn121090-20250113-00025
