COMBINATION THERAPY FOR MYELOFIBROSIS

Introduction.Ruxolitinib presents itself as a drug for the pathogenetic treatment of myelofibrosis (MF). New drugs have recently been developed for the treatment of MF. A search for optimal combinations of these drugs with ruxolitinib appears to be a logical approach to the development of MF therapy.Aim.To summarize data on the use of ruxolitinib in combination with various drugs approved or currently being studied in terms of their applicability for MF treatment.General findings.The review analyses data in publications retrieved from the PubMed and Elibrary.ru databases, including clinical cases, original research papers and reviews. We discuss preliminary results of clinical trials of various rational combination therapies, which have demonstrated a high efficacy for the forms of the disease untreatable with ruxolithinib monotherapy, e.g. bone marrow fibrosis and anemia. Combinations of ruxolithinib with azacytidine, panobinostat and α-interferon have shown the most promising results.

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Sezary's syndrome: report of a case showing peripheral neuropathy and bone marrow fibrosis

Archives of Dermatology ◽

10.1001/archderm.114.9.1360 ◽

1978 ◽

Vol 114 (9) ◽

pp. 1360-1362 ◽

Cited By ~ 2

Author(s):

H. Bargman

Keyword(s):

Bone Marrow ◽

Peripheral Neuropathy ◽

Bone Marrow Fibrosis ◽

Marrow Fibrosis ◽

Syndrome Report

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Faculty Opinions recommendation of Gli1+ mesenchymal stromal cells are a key driver of bone marrow fibrosis and an important cellular therapeutic target.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727567167.793534871 ◽

2017 ◽

Author(s):

Timothy Campbell

Keyword(s):

Bone Marrow ◽

Mesenchymal Stromal Cells ◽

Stromal Cells ◽

Therapeutic Target ◽

Bone Marrow Fibrosis ◽

Key Driver ◽

Marrow Fibrosis

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Prolonged Myelosuppression due to Progressive Bone Marrow Fibrosis in a Patient with Acute Promyelocytic Leukemia

Case Reports in Hematology ◽

10.1155/2019/1616237 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Yuta Inagawa ◽

Yukiko Komeno ◽

Satoshi Saito ◽

Yuji Maenohara ◽

Tetsuro Yamagishi ◽

...

Keyword(s):

Bone Marrow ◽

Acute Promyelocytic Leukemia ◽

Bone Marrow Biopsy ◽

Gastric Fluid ◽

Promyelocytic Leukemia ◽

Consolidation Therapy ◽

Bone Marrow Fibrosis ◽

All Trans Retinoic Acid ◽

Phlegmonous Gastritis ◽

Marrow Fibrosis

A 34-year-old woman was diagnosed with acute promyelocytic leukemia. Chemotherapy was administered following the JALSG APL204 protocol. Induction therapy with all-trans retinoic acid resulted in complete remission on day 49. She developed coccygeal pain from day 18, which spread to the spine and cheekbones and lasted 5 weeks. She had similar bone pain on days 7–10 of the first consolidation therapy and on days 4–12 of the second consolidation therapy. Oral loxoprofen was prescribed for pain relief. On day 33 of the third consolidation, white blood cell and neutrophil counts were 320/μL and 20/μL, respectively. After she developed epigastralgia and hematemesis, she developed septic shock. Gastroendoscopy revealed markedly thickened folds and diffusely damaged mucosa with blood oozing. Computed tomography revealed thickened walls of the antrum and the pylorus. Despite emergency treatments, she died. Bacterial culture of the gastric fluid yielded Enterobacter cloacae and enterococci growth. Collectively, she was diagnosed with phlegmonous gastritis. Retrospective examination of serial bone marrow biopsy specimens demonstrated progressive bone marrow fibrosis, which may have caused prolonged myelosuppression. Thus, evaluation of bone marrow fibrosis by bone marrow biopsy after each treatment cycle might serve as a predictor of persistent myelosuppression induced by chemotherapy.

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