{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T20:28:51Z","timestamp":1793737731053,"version":"4.6.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Ruxolitinib is a JAK1\/JAK2 inhibitor approved for the treatment of myelofibrosis (MF)\u2010related splenomegaly or symptoms. The recommended starting dose depends on platelet count, regardless of haemoglobin level at baseline. In the recent years, an overall survival (OS) advantage was reported in patients treated with ruxolitinib compared with best available therapy. We analysed a large Italian cohort of 3494 patients identified by Agenzia Italiana del Farmaco (AIFA) monitoring registries. Of them, 2337 (66.9%) started at reduced dose: these patients were older (median age 70 vs. 67), with increased incidence of large splenomegaly (longitudinal diameter 20 vs. 19.1\u2009cm, median volume 1064\u2009cm<jats:sup>3<\/jats:sup> vs. 1016\u2009cm<jats:sup>3<\/jats:sup>), with higher IPSS risk (30.9% vs. 26.1%), and worse ECOG score (more than 1 in 14.3% vs. 9.8%). After balancing for baseline characteristics, Kaplan\u2013Meier analysis showed a median OS of 78.2\u2009months (95% CI 65.9\u201389) for patients who started at full dose and 52.6 (95% CI 49\u201356.6) months for patients who started with reduced dose (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Group analysis also showed a substantial difference in patients with intermediate\u20102 and high IPSS risk. The majority of MF patients in real\u2010world analysis started with a reduced dose of ruxolitinib, which is associated with less favourable outcomes.<\/jats:p>","DOI":"10.1111\/bjh.19812","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T06:07:03Z","timestamp":1728022023000},"page":"172-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The impact of starting dose on overall survival in myelofibrosis patients treated with ruxolitinib: A prospective real\u2010world study on AIFA monitoring registries"],"prefix":"10.1111","volume":"206","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1163-6162","authenticated-orcid":false,"given":"Massimo","family":"Breccia","sequence":"first","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Celant","sequence":"additional","affiliation":[{"name":"AIFA Italian Medicines Agency  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8367-5668","authenticated-orcid":false,"given":"Francesca","family":"Palandri","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Istituto di Ematologia \u201cSer\u00e0gnoli\u201d  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8068-5289","authenticated-orcid":false,"given":"Francesco","family":"Passamonti","sequence":"additional","affiliation":[{"name":"Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7934-9034","authenticated-orcid":false,"given":"Pier Paolo","family":"Olimpieri","sequence":"additional","affiliation":[{"name":"AIFA Italian Medicines Agency  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Summa","sequence":"additional","affiliation":[{"name":"AIFA Italian Medicines Agency  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Guarcello","sequence":"additional","affiliation":[{"name":"AIFA Italian Medicines Agency  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Alberto","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Hematology with BMT Unit, A.O.U. \u201cG. 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