Pruritus in primary myelofibrosis: management options in the era of JAK inhibitors.
Primary myelofibrosis (PMF)-associated pruritus is often severe and requires treatment. Fifty-one patients with bone marrow-proven PMF with associated pruritus were identified from a primary cohort of patients with PMF (n = 566) seen at our institution. We conducted a retrospective review of the clinical characteristics, severity of pruritus, type of treatment, and response of these patients. Thirty-two out of 51 patients (63 %) reported severe PMF-associated pruritus and required a total of 108 treatment episodes, with complete response (CR), partial response (PR) and no response (NR) observed in 22, 23, and 55 % of episodes, respectively. The most common treatment categories included JAK inhibitors (n = 19), anti-depressants (n = 18), and antihistamines (n = 17). Highest CR rates were observed in patients treated with a JAK inhibitor (53 %) and immunomodulatory drugs (IMiDS (50 %)). Emerging targeted therapies may result in better symptom control and higher response rates in patients suffering from severe PMF-associated pruritus.
Department of Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN, USA.
Brianna E
BE
Vaa
Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Ayalew
A
Tefferi
Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Naseema
N
Gangat
Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Animesh
A
Pardanani
Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Terra L
TL
Lasho
Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Christy M
CM
Finke
Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Wolanskyj.alexandra@mayo.edu.|Department of Medicine, Mayo Clinic, Rochester, MN, USA. Wolanskyj.alexandra@mayo.edu.
Alexandra P
AP
Wolanskyj
D015331:Cohort Studies; D019468:Disease Management; D006801:Humans; D053612:Janus Kinases / Q000037:antagonists & inhibitors*; D055728:Primary Myelofibrosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D011537:Pruritus / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D012189:Retrospective Studies
D047428:Protein Kinase Inhibitors; D053612:Janus Kinases
JAK inhibitors; Primary myelofibrosis; Pruritus; Treatment options