{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T09:09:46Z","timestamp":1789808986785,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T00:00:00Z","timestamp":1555459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Ruxolitinib, an orally bioavailable and selective inhibitor of Janus kinase 1 (JAK1) and JAK2, significantly reduces splenomegaly and disease\u2010related symptoms in patients with myelofibrosis (MF). However, no clear survival benefit has been demonstrated, which may in part reflect suboptimal drug exposure related to lower dosages needed to minimize hematological toxicity, specifically cytopenias. Furthermore, the optimal management of specific conditions such as leukocytosis or thrombocytosis in patients under ruxolitinib therapy is still undefined. In these cases, combining ruxolitinib with a cytoreductive agent like hydroxyurea might improve hematological response. This observational multi\u2010center study enrolled 20 adult patients with intermediate\u2010 or high\u2010risk primary MF, post\u2010 polycythemia vera MF, or postessential thrombocythemia MF with hyperproliferative manifestations of the disease and WBC and\/or platelet counts not controlled by ruxolitinib therapy. The patients received treatment with a combination of ruxolitinib and hydroxyurea. A clinical response of any type was obtained in 8 patients (40%) during ruxolitinib monotherapy and in 17 patients (85%) during ruxolitinib\u2010hydroxyurea combination (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003). After a median duration of 12.4\u00a0months of combination therapy, 16\/20 patients had a hematological response; 14\/17 patients who had started combination therapy to control WBC count and 2\/3 who started in order to reduce platelets count. The number of patients requiring ruxolitinib dosage reduction or discontinuations was lower during combination therapy and, at the end of follow\u2010up the median ruxolitinib dose was increased in 50% of patients. In conclusion, the combination of hydroxyurea with ruxolitinib yielded a high clinical response rate and increased ruxolitinib exposure in patients with hyperproliferative forms of MF.<\/jats:p>","DOI":"10.1002\/cam4.2147","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T04:09:49Z","timestamp":1555560589000},"page":"2802-2809","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Adding hydroxyurea in combination with ruxolitinib improves clinical responses in hyperproliferative forms of myelofibrosis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2714-5109","authenticated-orcid":false,"given":"Novella","family":"Pugliese","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery Hematology and Hematopoietic Stem Cell Transplant Center University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery Hematology and Hematopoietic Stem Cell Transplant Center University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Nappi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery Hematology and Hematopoietic Stem Cell Transplant Center University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigiana","family":"Luciano","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery Hematology and Hematopoietic Stem Cell Transplant Center University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Cerchione","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery Hematology and Hematopoietic Stem Cell Transplant Center University of Naples Federico II Naples Italy"},{"name":"Hematology Unit Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS Meldola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Annunziata","sequence":"additional","affiliation":[{"name":"Hematology Unit A.O.R.N. Antonio Cardarelli Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beniamino","family":"Casale","sequence":"additional","affiliation":[{"name":"Hematology Unit AO Ospedali dei Colli Napoli, PO Monaldi Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cris\u00e0","sequence":"additional","affiliation":[{"name":"Hematology Division Universit\u00e0 degli Studi di Torino Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosaria","family":"Villa","sequence":"additional","affiliation":[{"name":"Hematology Unit Ospedale Ascalesi Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Pezzullo","sequence":"additional","affiliation":[{"name":"Hematology and Hematopoietic Stem Cell Transplant Center A.U.O. 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