{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:13:51Z","timestamp":1778753631213,"version":"3.51.4"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007069","name":"Universit\u00e0 della Calabria","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007069","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Hematol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ruxolitinib is standard first-line therapy for symptomatic myelofibrosis (MF). In real-world practice, dose reductions are common, and the impact of maintaining higher dose intensity over time remains incompletely characterized\u2014particularly for patients escalated to 25\u00a0mg twice daily (50\u00a0mg\/day; full dose).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center retrospective cohort study of consecutive MF patients (2015\u20132025) who received 25 mg BID at least once during their treatment course. Data were extracted from a structured institutional database linking baseline (DEMOGRAPHY) and visit-level longitudinal data (HISTORY), including dosing, supportive care, infections, transfusions, and spleen measurements. Dose-intensified exposure was defined as 40 mg\/day or higher and was used to anchor t0 (first visit at 40 mg\/day or higher), while full-dose exposure specifically referred to the approved maximum of 50 mg\/day (25 mg twice daily). FRAC_EQ50 quantified sustained full-dose exposure as the fraction of visits at 50 mg\/day. Analyses were descriptive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-four patients were included, with a median follow-up of 60.9 months from ruxolitinib initiation. Based on FRAC_EQ50, 11\/24 patients were classified as high-intensity (FRAC_EQ50 0.50\u20131.00), 6\/24 as intermediate (0.10\u20130.49), and 7\/24 as minimal (below 0.10). For spleen-response analyses, baseline was defined as the first ultrasound spleen length recorded after t0 and was available in 22\/24 patients; spleen response was evaluable in 21\/24 (one patient lacked a follow-up ultrasound with spleen length in cm; two had no evaluable post-baseline spleen assessments). Spleen length decreased in 17\/21 evaluable patients (81.0%), while hematologic toxicities and supportive-care needs remained manageable across intensity groups. Four deaths occurred during follow-up, including one fatal COVID-19 case temporally associated with abrupt ruxolitinib discontinuation during ICU intubation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In selected MF patients, escalation to 25 mg BID with sustained full-dose intensity appears feasible in routine practice, with durable treatment exposure and manageable safety. These real-world data support further multicenter efforts to better characterize longitudinal dose exposure and its potential clinical implications, without implying causal relationships.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00277-026-07020-1","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:17:58Z","timestamp":1777864678000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-dose ruxolitinib (25\u00a0mg twice daily) in myelofibrosis: feasibility, safety, and long-term treatment exposure in a real-world cohort"],"prefix":"10.1007","volume":"105","author":[{"given":"Francesco","family":"Mendicino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Carid\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Bruzzese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrica Antonia","family":"Martino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santino","family":"Caserta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Amodio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenio","family":"Lucia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Olivito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Labanca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Eugenia","family":"Alvaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Luciani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fortunato","family":"Morabito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernesto","family":"Vigna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Gentile","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"7020_CR1","doi-asserted-by":"publisher","unstructured":"Mascarenhas J, Gleitz HFE, Chifotides HT et al (2023) Biological drivers of clinical phenotype in myelofibrosis. 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