Andrew Kuykendall, MD, assistant member, the Department of Malignant Hematology, Moffitt Cancer Center, discusses treatment considerations with ruxolitinib (Jakafi) in myelofibrosis.

Although a need for more beneficial agents remains in myelofibrosis, clinicians currently have more options to consider when making treatment decisions, Kuykendall says. In the current era of myelofibrosis treatments, some options may be more beneficial for some patients than others, Kuykendall adds.

The RR6 model was created to help clinicians predict which patients treated with ruxolitinib may not benefit in the same way as others, allowing those patients to potentially be selected for a change of therapy or enrollment in a clinical trial, Kuykendall explains.

The key factors the RR6 model looks at include suboptimal ruxolitinib dosing, the need for transfusions, and a suboptimal spleen response, Kuykendall explains. If these characteristics are present, a patient may benefit more from a different therapy, Kuykendall concludes.

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Andrew Kuykendall, MD, discusses treatment considerations with ruxolitinib in myelofibrosis.


Dr. Kuykendall on Treatment Considerations with Ruxolitinib in Myelofibrosis

Andrew Kuykendall, MD, assistant member, the Department of Malignant Hematology, Moffitt Cancer Center, discusses the evolution of prognostication factors in primary and secondary myelofibrosis.

The heterogeneous nature of myelofibrosis highlights the importance of disease prognostication at all stages, Kuykendall says. Although early prognostic models used over a decade ago were based on clinical factors such as white blood cell count, hemoglobin levels, platelets, age, constitutional symptoms, and circulating blasts, now, prognostication increasingly includes genetics, which drive much of the heterogeneity of this disease, Kuykendall explains. Newer prognostication models build on the clinical factors of past models by also including specific mutations and the number of mutations a patient has, Kuykendall notes.

Additionally, unique prognostic models have been developed for patients who have secondary myelofibrosis, which is myelofibrosis that occurs after prior essential thrombocythemia or polycythemia vera, Kuykendall says. Moving toward more individualized care has allowed for the evolution of increasingly effective treatment strategies, as well as a better understanding of each patient’s risk, Kuykendall concludes.

Andrew Kuykendall, MD, discusses the evolution of prognostication factors in primary and secondary myelofibrosis.

Andrew Kuykendall, MD

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Dr. Kuykendall on Treatment Considerations with Ruxolitinib in Myelofibrosis

Dr. Kuykendall on Prognostication Factors in Myelofibrosis