NCCN Guidelines for Patients® | Myeloproliferative Neoplasms

46 NCCN Guidelines for Patients ® : Myeloproliferative Neoplasms, 2018 Ruxolitinib Ruxolitinib is an FDA-approved treatment for INT- and high-risk MF. Among these groups, it has reduced spleen size, improved symptoms, and may extend life in some people. It does not reduce the risk of progression to AML. NCCN experts recommend ruxolitinib as an option for low- and INT-1-risk MF when symptoms are present. A study on preexisting data found that spleens shrunk and symptoms improved during treatment in these groups. Well-designed studies are needed to learn how well ruxolitinib works in early MF. Hydroxyurea and interferon Interferon and hydroxyurea are options for low-risk MF with symptoms. Both control MF by reducing the number of blood cells. Cell counts may return to normal levels. There is limited research on interferon. Results suggest that interferon prevents cancer progression in a subset of people with early MF. It may reverse bone marrow changes and shrink enlarged spleens. More research is needed. Interferon doesn’t work if there is advanced myelofibrosis. Hydroxyurea may help some people. It helps to lower high blood counts, especially white blood cells and platelets. It may decrease spleen size. However, the decrease is usually modest. Hydroxyurea may reduce certain symptoms. In particular, symptoms caused by high blood counts may decrease. If hydroxyurea doesn’t work, interferon or ruxolitinib may be an option. 5 Myelofibrosis Initial treatment My PMF has been indolent and progressing very slowly. Exercise and a good diet have helped my quality of life. – Vivian Survivor, Primary myelofibrosis “