Supplementary Material for: Impact of Early-Onset or Worsening Anemia in Patients With Myelofibrosis Treated With Ruxolitinib: A Post Hoc Analysis of the JUMP Study

Introduction: Anemia can influence decisions regarding initiation, dosing, and discontinuation of Janus kinase inhibitor therapy for myelofibrosis. We evaluated the impact of new-onset or worsening anemia following ruxolitinib initiation on spleen response, symptom severity, and overall survival in patients with myelofibrosis.

Methods: This post hoc analysis used data from all patients enrolled in the phase 3b JUMP trial. Outcomes were stratified by presence or absence of new-onset or worsening anemia following ruxolitinib initiation, defined as hemoglobin decrease ≥15 g/L from baseline and hemoglobin <100 g/L (female)/<110 g/L (male) at Week 12, new transfusion requirement post-baseline until Week 12 (for baseline non–transfusion-dependent patients), or ≥50% increase from baseline in RBC transfusions through Week 12.

Results: Overall, 2233 patients were included; 52.9% developed new-onset or worsening anemia up to Week 12. Ruxolitinib was associated with improvements in spleen length and myelofibrosis symptoms regardless of presence or absence of new-onset or worsening anemia or baseline anemia status. No differences in spleen response or overall survival were observed between patients with versus without new-onset or worsening anemia, regardless of baseline anemia status.

Conclusions: These results support the use of ruxolitinib in patients with myelofibrosis regardless of baseline anemia or development of treatment-related anemia.

引言：贫血可影响骨髓纤维化患者贾努斯激酶抑制剂（Janus kinase inhibitor）治疗的启动、剂量调整及停药决策。本研究评估了芦可替尼启动治疗后新发或加重的贫血对骨髓纤维化患者脾脏应答、症状严重程度及总生存期的影响。

方法：本事后分析纳入了3b期JUMP临床试验中所有入组患者的数据。研究结局根据芦可替尼启动治疗后新发或加重贫血的发生情况进行分层，贫血定义为：第12周时血红蛋白较基线下降≥15 g/L且血红蛋白浓度女性<100 g/L/男性<110 g/L；基线非输血依赖患者于基线后至第12周期间出现新的输血需求；或至第12周时红细胞（Red Blood Cell, RBC）输注量较基线增加≥50%。

结果：共纳入2233例患者，其中52.9%的患者在第12周前出现新发或加重的贫血。无论是否出现新发或加重的贫血，以及基线贫血状态如何，芦可替尼均可改善脾脏长度及骨髓纤维化相关症状。无论基线贫血状态如何，出现与未出现新发或加重贫血的患者之间，脾脏应答及总生存期均无显著差异。

结论：本研究结果支持骨髓纤维化患者使用芦可替尼，无论其基线是否存在贫血或是否出现治疗相关性贫血。