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JAK2 INHIBITORS AND ALLOGRAFTING Andrea Bacigalupo , Genova, Italy

JAK2 INHIBITORS AND ALLOGRAFTING Andrea Bacigalupo , Genova, Italy. Significant reduction of spleen size with ruxolitinib. Significant survival advantage for ruxolitinib. Thus spleen size = progression Reduction of spleen size = control of progression

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JAK2 INHIBITORS AND ALLOGRAFTING Andrea Bacigalupo , Genova, Italy

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  1. JAK2 INHIBITORS AND ALLOGRAFTING Andrea Bacigalupo, Genova, Italy

  2. Significantreduction of spleen size with ruxolitinib

  3. Significantsurvivaladvantage for ruxolitinib

  4. Thus spleen size = progressionReduction of spleen size = control of progression Reduction of tumourmasss? survivaladvantageissuperior with greater spleen sizereduction

  5. results of allogeneic hemopoietic stem cell transplants (HSCT) are dependent on disease phase # DIPSS # Spleen size, transfusion requirement

  6. results of allogeneic hemopoietic stem cell transplants (HSCT) are dependent on disease phase # DIPSS # Spleen size, transfusion requirement

  7. SPLEEN SIZE AND SURVIVAL in 70 allograftedMF (GE SM) Spleen <22 cm; n=29 68% 23% Spleen >22 cm; n=31 P=0.0008

  8. CD34 PB cellcounts and SURVIVAL in 70 allograftedMF (GE SM) CD34 <8 /cmm n=13 66% CD34 9-486/cmmn=30 38% 24% CD34 >486/cmmn=15 Days from transplant

  9. Spleen size and CD34 cell count P=0.01 CD34 cellcounts

  10. Patients with a large spleen have advanced disease Survival after allogeneic transplant is worse in patients with a large spleen Survival after allogeneic transplant is also worse in patients with high CD34 counts High CD34 counts correlate with large spleen

  11. JAK2 inhibitors can reduce spleen size JAK2 inhibitors are good candidates for treatment BEFORE an allogeneic transplant Also AFTER an allogeneic transplant

  12. Cervantes et al Blood 2009; 113: 2895: IPSS Death rate Low = 5% /year Int-1 = 6.7% /year Int-2 = 8.3% /year High = 25% /year

  13. Goodoutcomeafter SCT Pooroutcomeafter SCT

  14. Riulitinib Reduction of tumourmass ImprovedoutcomeafterSCT ?? Goodoutcomeafter SCT

  15. Conclusion SCT transplant outcome is dependent on disease phase Ruxolitinib may improve SCT outcome for patients with advanced disease

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