P224 | USE OF RUXOLITINIB IN THE TREATMENT OF MYELOFIBROSIS: SINGLE-CENTER "REAL LIFE" ANALYSIS ON THERAPY MANAGEMENT, EFFICACY, AND ADHERENCE IN ANEMIC PATIENTS

Introduction Myelofibrosis (MF) is a chronic myeloproliferative disorder characterized by bone marrow fibrosis, splenomegaly, anemia, and systemic symptoms. Ruxolitinib is the first approved treatment for MF to reduce spleen size and alleviate symptoms. Given the high prevalence of anemia in MF—and its potential exacerbation by Ruxolitinib—the management of anemia is critical. Data from the REALISE study and analyses from the JUMP trial support the use of individualized dosing regimens in anemic MF patients. This single-center study aims to evaluate the management of ruxolitinib in a group of anemic MF patients. Methods Clinical data were collected using outpatient medical records (Tab.1). Spleen size was investigated by ultrasound examination. Response to treatment was evaluated according to the 2013 IWG-MRT criteria. For defining adverse drug reactions (ADRs) was used Common Terminology Criteria for Adverse Events version 5.0, 2017; treatment adherence was calculated with PDD/RDD system. For survival data Kaplan-Meier method was applied. Results From January 2015 to April 2024 31 patients affected by MF were included. The median hemoglobin (Hb) value at diagnosis was 9.1 g/dl. Ruxolitinib treatment was individualized, with 61% of patients starting on a reduced dose. 26% of patients increased the dose due to loss of response, while 19% reduced the dose because of adverse events. 58% of patients achieved >35% reduction in spleen volume after a median time of 5 months. All patients with systemic symptoms reported clinical improvement. 35% of patients maintained stable blood counts and spleen size during treatment. The 24-month overall survival (OS) exceeded 80%, with nearly 50% of patients remaining on treatment at 24 months and 50% alive at 6 years (Fig1). ADRs were observed in 58% of patients; among Hematologic ADRs 63% were thrombocytopenia (12% grade 3); No ADR lead to permanent treatment discontinuation. A high mean adherence level of 0.92 ± 0.12 was maintained. When patients changed doses, better treatment persistence was recorded (50% at 24 months). Conclusion This analysis confirms that Ruxolitinib is effective in managing MF even among patients with significant baseline anemia; starting treatment with reduced dosages to mitigate anemia-related risks, allows splenic response and symptom control preserving overall survival. Future research should continue to refine dosing strategies and explore combination therapies to enhance patient outcomes.