Ruxolitinib is approved for treating myelofibrosis and also has shown efficacy in treating steroid-resistant acute and chronic graft-versus-host disease (GVHD). In this study of 12 patients with myelofibrosis (median age 63 years, range 43 to 71), ruxolitinib administered both before and after hematopoietic cell transplantation (HCT) resulted in an 8% incidence of acute GVHD grade II-IV at day +100, with no non-relapse mortality.
No graft failure was observed, and complete chimerism was achieved in 11 patients after a median of 40 days. All patients were alive at a median follow-up of 17 months (range, 12 to 18).
After day +100, 4 patients developed acute GVHD (1 with grade I, 2 with grade II, and 1 with grade III) after tapering of cyclosporine. Levels of inflammatory cytokines IL-8, IL-10, IL-6, TNFR2, INF-α, and INF-β were reduced after ruxolitinib treatment.
The researchers concluded that “ruxolitinib given during peritransplantation period in patients with myelofibrosis is well tolerated, reduces cytokine release induced by the conditioning regimen and ATG, ensures safe and fast engraftment, and leads to a low incidence of acute GVHD.”