Ruxolitinib in myelofibrosis: solutions for side effects and treatment failure

Myelofibrosis(MF) is a type of myeloproliferative neoplasms which is difficult to be treated. With the discovery of V617F mutation in Janus kinase(JAK)2, JAK inhibitor provides a new treatment strategy for patients with myelofibrosis.Ruxolitinib is the first JAK1/2 inhibitor which approved by the Food and Drug Administration(FDA) for the treatment of patients with international prognostic scoring system(IPSS)intermediate-2 or high risk myelofibrosis. In clinical experiments, ruxolitinib demonstrates significant improvements in splenomegaly and disease-related constitutional symptoms, and prolongs patients′ overall survival. However, the side effects of the drug (hematocytopenia, infections and secondary neoplasms) and treatment failure of some patients has been observed in treatments. The adverse reaction and solutions of ruxlitinib; the definition, reason, high risk factors and prognosis of treatment failure; the salvage therapy after treatment failure will be discussed in this review. Key words: Primary myelofibrosis; Janus kinases; Treatment failure; Salvage therapy; Adverse reaction; Ruxolitinib