Risk of hepatitis B reactivation in patients with myeloproliferative neoplasms treated with ruxolitinib

Abstract

Classical Philadelphia-negative myeloproliferative neoplasms (MPNs), i.e., polycythemia vera, essential thrombocythemia, and primary/secondary myelofibrosis, are clonal disorders of the hematopoietic stem cell in which an uncontrolled proliferation of terminally differentiated myeloid cells occurs. MPNs are characterized by mutations in driver genes, the JAK2V617F point mutation being the most commonly detected genetic alteration in these hematological malignancies. Thus, JAK inhibition has emerged as a potential therapeutic strategy in MPNs, with ruxolitinib being the first JAK inhibitor developed, approved, and prescribed in the management of these blood cancers. However, the use of ruxolitinib has been associated with a potential risk of infection, including opportunistic infections and reactivation of hepatitis B. Here, we briefly describe the association between ruxolitinib treatment in MPNs and hepatitis B reactivation.

Keywords: Ruxolitinib; Myeloproliferative neoplasms; Hepatitis B; Polycythemia vera; Myelofibrosis; JAK inhibitor

Core Tip: The JAK inhibitor ruxolitinib has been approved for the treatment of classical Philadelphia-negative myeloproliferative neoplasms (MPNs), i.e., polycythemia vera, essential thrombocythemia and primary/secondary myelofibrosis. However, its use has been associated with a potential risk of opportunistic infections, including hepatitis B reactivation. Herein, we briefly overview the association between ruxolitinib treatment in MPNs and hepatitis B reactivation.