EHA 2026 | Predictors of infection in patients with myelofibrosis receiving ruxolitinib

So, infections are a leading cause of morbidity and mortality in myelofibrosis patients, and this is particularly true when we use Ruxolitinib in our routine clinical practice. So we performed a sub-analysis on the Ruxolitinib cohort retrospective study in Italy and we wanted to analyze the incidence of infections and also we wanted to analyze what were the predictors of infections in these so fragile populations. We observed that the rate of infections was around 30 percent so quite high particularly bacterial and we also observed that two main parameters were significantly associated with an increased risk of infections. The first one was iron overload and transfusion dependency. So we really got a correlation between anemia severity, which translates into a higher burden of transfusions, and then increased risk of infections. The second predictor of infection that we found was NLR, the neutrophil to lymphocyte ratio, which is a measure in which we evaluate the pro-inflammatory status of the patients. And we really observe that the NLR higher than 3.73 was significantly associated with an increased risk, again, of infections. So taken together, these two parameters just can be summarized in two key clinical messages. First, it is important to address anemia aggressively because anemia is not only a survival factor, but it can also lead to many clinical consequences that may severely impair the quality of life of the patient, not only the survival expectations. And second, the inflammatory status of the patient is a very important target for treatment and should be more valued during our monitoring of the patients on Ruxolitinib therapy.

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