{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T08:05:01Z","timestamp":1789632301673,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T00:00:00Z","timestamp":1679097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RC\u20102022\u20102773427"],"award-info":[{"award-number":["RC\u20102022\u20102773427"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with cytopenic myelofibrosis (MF) have more limited therapeutic options and poorer prognoses compared with patients with the myeloproliferative phenotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and Methods<\/jats:title><jats:p>Prognostic correlates of cytopenic phenotype were explored in 886 ruxolitinib\u2010treated patients with primary\/secondary MF (PMF\/SMF) included in the RUX\u2010MF retrospective study. Cytopenia was defined as: leukocyte count &lt;4\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L and\/or hemoglobin &lt;11\/&lt;10\u00a0g\/dL (males\/females) and\/or platelets &lt;100\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 407 (45.9%) patients had a cytopenic MF, including 249 (52.4%) with PMF. In multivariable analysis, high molecular risk mutations (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.04), intermediate 2\/high Dynamic International Prognostic Score System (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and intermediate 2\/high Myelofibrosis Secondary to Polycythemia Vera and Essential Thrombocythemia Prognostic Model (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) remained associated with cytopenic MF in the overall cohort, PMF, and SMF, respectively. Patients with cytopenia received lower average ruxolitinib at the starting (25.2\u00a0mg\/day vs. 30.2\u00a0mg\/day, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and overall doses (23.6\u00a0mg\/day vs. 26.8\u00a0mg\/day, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) and achieved lower rates of spleen (26.5% vs. 34.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04) and symptom (59.8% vs. 68.8%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.008) responses at 6\u00a0months compared with patients with the proliferative phenotype. Patients with cytopenia also had higher rates of thrombocytopenia at 3\u00a0months (31.1% vs. 18.8%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) but lower rates of anemia (65.6% vs. 57.7%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.02 at 3\u00a0months and 56.6% vs. 23.9% at 6\u00a0months, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). After competing risk analysis, the cumulative incidence of ruxolitinib discontinuation at 5\u00a0years was 57% and 38% in patients with cytopenia and the proliferative phenotype (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), whereas cumulative incidence of leukemic transformation was similar (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.06). In Cox regression analysis adjusted for Dynamic International Prognostic Score System score, survival was significantly shorter in patients with cytopenia (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cytopenic MF has a lower probability of therapeutic success with ruxolitinib as monotherapy and worse outcome. These patients should be considered for alternative therapeutic strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34722","type":"journal-article","created":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T10:23:44Z","timestamp":1679135024000},"page":"1704-1713","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Ruxolitinib in cytopenic myelofibrosis: Response, toxicity, drug discontinuation, and outcome"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8367-5668","authenticated-orcid":false,"given":"Francesca","family":"Palandri","sequence":"first","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1163-6162","authenticated-orcid":false,"given":"Massimo","family":"Breccia","sequence":"additional","affiliation":[{"name":"Division of Cellular Biotechnologies and Hematology University Sapienza  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6398-7074","authenticated-orcid":false,"given":"Camilla","family":"Mazzoni","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Universit\u00e0 di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Auteri","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Universit\u00e0 di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5576-5412","authenticated-orcid":false,"given":"Elena Maria","family":"Elli","sequence":"additional","affiliation":[{"name":"Hematology Division San Gerardo Hospital ASST Monza  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata M.","family":"Trawinska","sequence":"additional","affiliation":[{"name":"Hematology Sant\u2019Eugenio Hospital Tor Vergata University  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6297-9697","authenticated-orcid":false,"given":"Nicola","family":"Polverelli","sequence":"additional","affiliation":[{"name":"Unit of Blood Diseases and Stem Cell Transplantation ASST Spedali Civili di Brescia  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9449-2621","authenticated-orcid":false,"given":"Mario","family":"Tiribelli","sequence":"additional","affiliation":[{"name":"Division of Hematology and BMT Azienda Sanitaria Universitaria Integrata di Udine  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3200-9654","authenticated-orcid":false,"given":"Giulia","family":"Benevolo","sequence":"additional","affiliation":[{"name":"Division of Hematology Citt\u00e0 della Salute e della Scienza Hospital  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4401-0812","authenticated-orcid":false,"given":"Alessandra","family":"Iurlo","sequence":"additional","affiliation":[{"name":"Hematology Division Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Tieghi","sequence":"additional","affiliation":[{"name":"Department of Hematology Azienda USL \u2010 IRCCS di Reggio Emilia  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian H.","family":"Heidel","sequence":"additional","affiliation":[{"name":"Innere Medicine C Universit\u00e4tsmedizin Greifswald  Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Caocci","sequence":"additional","affiliation":[{"name":"Hematology Unit Department of Medical Sciences University of Cagliari  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloise","family":"Beggiato","sequence":"additional","affiliation":[{"name":"Division of Hematology Citt\u00e0 della Salute e della Scienza Hospital  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni","family":"Binotto","sequence":"additional","affiliation":[{"name":"Unit of Hematology and Clinical Immunology University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cavazzini","sequence":"additional","affiliation":[{"name":"Division of Hematology University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Miglino","sequence":"additional","affiliation":[{"name":"Clinic of Hematology Department of Internal Medicine (DiMI) University of Genoa  Genova Italy"},{"name":"IRCCS Policlinico San Martino  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costanza","family":"Bosi","sequence":"additional","affiliation":[{"name":"Division of Haematology AUSL di Piacenza  Piacenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Crugnola","sequence":"additional","affiliation":[{"name":"Division of Hematology Azienda Ospedaliero\u2010Universitaria di Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Bocchia","sequence":"additional","affiliation":[{"name":"Hematology Unit Azienda Ospedaliera Universitaria Senese University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Martino","sequence":"additional","affiliation":[{"name":"Division of Hematology Azienda Ospedaliera 'Bianchi Melacrino Morelli'  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2714-5109","authenticated-orcid":false,"given":"Novella","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Hematology Section University of Naples \"Federico II\"  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Biondo","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Universit\u00e0 di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Venturi","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Universit\u00e0 di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Scaffidi","sequence":"additional","affiliation":[{"name":"Section of Hematology Department of Medicine University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Isidori","sequence":"additional","affiliation":[{"name":"Haematology and Haematopoietic Stem Cell Transplant Center AORMN Hospital  Pesaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Hematology Division Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Krampera","sequence":"additional","affiliation":[{"name":"Section of Hematology Department of Medicine University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Pane","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Hematology Section University of Naples \"Federico II\"  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Cilloni","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpietro","family":"Semenzato","sequence":"additional","affiliation":[{"name":"Unit of Hematology and Clinical Immunology University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto M.","family":"Lemoli","sequence":"additional","affiliation":[{"name":"Clinic of Hematology Department of Internal Medicine (DiMI) University of Genoa  Genova Italy"},{"name":"IRCCS Policlinico San Martino  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Cuneo","sequence":"additional","affiliation":[{"name":"Division of Hematology University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-6491","authenticated-orcid":false,"given":"Elisabetta","family":"Abruzzese","sequence":"additional","affiliation":[{"name":"Hematology S. Eugenio Hospital ASLRoma2  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Bartoletti","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Universit\u00e0 di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Paglia","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Vianelli","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Cavo","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia \u201cSer\u00e0gnoli\u201d IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"},{"name":"Dipartimento di Medicina Specialistica Diagnostica e Sperimentale Universit\u00e0 di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-1686","authenticated-orcid":false,"given":"Massimiliano","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Hematology Section University of Naples \"Federico II\"  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe A.","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Department of Scienze Mediche Chirurgiche e Tecnologie Avanzate \u201cG.F. Ingrassia\u201d University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra063728"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2020.01.008"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14601"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2020.106338"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13005"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102010\u201006\u2010293415"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2010.32.2446"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16380"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2017.169"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2006.12.025"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21644"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408\u2010022\u201000713\u20106"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1110556"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1110557"},{"key":"e_1_2_8_16_1","volume-title":"European Medicines Agency","author":"JAKAVI (ruxolitinib) summary of product characteristics","year":"2019"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010017\u20100417\u2010z"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2022.08.011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102016\u201003\u2010643544"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2012.42.3863"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102013\u201003\u2010488098"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2013.119"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.18674"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2018.10.001"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010017\u20100527\u20107"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277\u2010021\u201004682\u2010x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102021\u2010150894"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010021\u201001261\u2010x"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16729"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201004\u2010214957"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1002028"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32664"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2352\u20103026(17)30088\u20101"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25777"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000954"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.1590"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.5818"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.279415"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003314"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020002662"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2022.2043304"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.34722","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.34722","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.34722","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T18:56:52Z","timestamp":1760295412000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.34722"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,18]]},"references-count":40,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/cncr.34722"],"URL":"https:\/\/doi.org\/10.1002\/cncr.34722","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,18]]},"assertion":[{"value":"2022-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}