To report a case of a 74-year-old female with secondary myelofibrosis who was switched from ruxolitinib to momelotinib due to anemia and subsequently reintroduced to ruxolitinib after experiencing significant peripheral neuropathy and arthralgias from momelotinib.
Approach:
Case Presentation: A 74-year-old female with secondary myelofibrosis was initially treated with high-dose ruxolitinib, switched to momelotinib for transfusion-dependent anemia, and later re-switched to low-dose ruxolitinib due to significant peripheral neuropathy and arthralgias that were not managed effectively by dose reductions.
Key Findings:
The patient developed significant peripheral neuropathy and arthralgias while on momelotinib, which were not managed effectively by dose reductions.
After switching back to low-dose ruxolitinib, the patient experienced resolution of neuropathy and maintained anemia control.
Interpretation:
This case illustrates the potential for reintroducing ruxolitinib after momelotinib-related toxicity in managing symptoms and adverse effects in patients with myelofibrosis.
Limitations:
This is a single case report, limiting the generalizability of the findings.
Lack of data on the long-term outcomes of ruxolitinib rechallenge after momelotinib.
Conclusion:
The case highlights the sequencing of JAK inhibitors in the management of myelofibrosis, particularly in the context of adverse effects.
