Laboratory/Symptom Monitoring

Weekly CBC monitoring is reasonable when starting a new therapy, especially in light of the patient’s hemoglobin levels and the development of thrombocytopenia within the first month of treatment. 

Anemia is an expected dose-dependent side effect of ruxolitinib, and Mr M required blood transfusions twice monthly during the first 2 months of therapy. An important note is that the development of anemia does not limit the efficacy of ruxolitinib, and patients still feel better despite developing a transient, therapy-related anemia. Improvement often occurs after an initial decline in hemoglobin levels, and patients may no longer need transfusions.Once a patient is stable, reducing follow-up to once monthly and then every 3 months is generally acceptable. 

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Mr M continues to have symptomatic improvement and stable laboratory values with infrequent packed red blood cell transfusions. His spleen has decreased in size considerably. He continues to follow-up with pulmonology at this time; however, no interventions have been initiated for the previously diagnosed pulmonary hypertension. We will continue a team approach to managing Mr M’s treatment.


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