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Ruxolitinib Withdrawal Syndrome (Ruxolitinib Discontinuation Syndrome)

Description

Ruxolitinib (INCB018424) is an inhibitor of JAK1 and JAK2 used in the treatment of myelofibrosis. Discontinuation of therapy may be followed by a withdrawal reaction that can be severe. This syndrome may be mediated by rapid changes in cytokine activity.


 

Patient selection: discontinuation of ruxolitinib therapy

 

Features of the withdrawal syndrome:

(1) relapse in disease symptoms (fatigue, night sweats, etc)

(2) accelerated splenomegaly

(3) worsening of cytopenias (anemia, thrombocytopenia, leucopenia)

(4) respiratory distress

(5) hemodynamic decompensation include septic shock syndrome

 

The diagnosis requires exclusion of alternative explanations for the findings such as sepsis.

 


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