Problem kontroli leukocytozy u chorego na pierwotne włóknienie szpiku leczonego ruksolitynibem

Ruxolitynib — JAK1/JAK2 inhibitor — registrated for patients with myelofibrosis (MF) IPSS (International Prognostic Scoring System) intermediate-2 or high, with splenomegaly and general symptomatology. Moreover, ruxolitinib is used to reduce splenomegaly and general symptomatology in patients with MF who are candidates for allogeneic hematopoietic stem cells transplantation (allo- -HSCT). Anemia, thrombocytopenia and occasionally leukopenia with neutropenia are observed as a main side effects of ruxolitinib. Moreover, there are problems related to cytokine storm caused by treatment discontinuation. Here we report the patient with MF and important leucocytosis, in whom splenomegaly and general symptoms were reduced due to ruxolitinib. However, ruxolitinib in monotherapy did not reduce the leukocyte count, so the the combined therapy with ruxolitinib plus hydroxycarbamide was initiated. As the result of the treatment, reduction of number of leukocytes was observed, meanwhile the level of hemoglobin was stable and platelets count drop slightly. Thereafter, the patient proceeded to allo-HSCT. So far, there are two cases of patients treated with ruxolitinib plus hydroxycarbamid published in the literature. We think, that all cases treated in that way, should be reporteds, as we can establish the safety of this drug combination.