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| Lymphoma News Today has a more about the Jakafi- lymphoma link. |
Jakafi was first approved by the U.S. Food and Drug Administration for myelofibrosis patients in 2011. Jakafi was approved for polycythemia vera patients a few years later. It is not yet officially approved for use in ET patients, but some doctors prescribe it "off-list" if ET patients aren't responding to hydroxyurea or anagrelide (trade names Hydrea and Agrylin).
Jakafi has worked better than other treatments for some MPN patients by reducing spleen size, improving symptoms, and generally enhancing quality of life.
However, the European studies showed that patients taking Jakafi were 15 times more likely to develop B-cell lymphoma than those taking other drugs. Most of those who developed lymphoma had myelofibrosis (MF).
When researchers went back to look at the bone marrow test results of the patients who developed lymphoma, they discovered that they were also carrying a B-cell clone. (B-cell clones can also be detected with a blood test.) The median time between starting Jakafi and lymphoma onset was about two years.
So: Jakafi + B-cell clone = B-cell lymphoma, right? No, it's never that simple.
First, let's be clear about terminology:
A link or association between Jakafi and lymphoma does not mean that Jakafi actually causes the lymphoma, though many patients would understandably be concerned about taking Jakafi if they had B-cell clones.
The median time it took some patients to develop lymphoma is not the same as the average time. Median means that half of the patients who developed lymphoma did so before 25 months, and half of them developed lymphoma after 25 months.
Patients who took Jakafi developed lymphoma at a rate 15 times higher than those on another drug. That sounds scary. But this is not the same as the percentage of patients who developed lymphoma. The percentage of patients taking Jakafi who developed lymphoma was 3.5 to 6 percent overall, with a 9 percent increase among MF patients.
Second, there are lots of variables researchers need to look at: For instance, is your type of MPN a factor? Is your type of mutation a factor? Would other drugs in the Jakafi family produce similar associations with lymphoma? Would patients with B-cell clones have developed lymphoma anyway?
In the coming years, more studies will be done on Jakafi and its sister drugs, and doctors will be monitoring and reporting patient problems with Jakafi.
The bottom line for you as a patient is to be aware of possible risks associated with Jakafi. An editorial in Blood journal in September called for doctors to discuss possible risks of Jakafi with patients, to screen them for B-cell mutations, and to monitor them frequently.
Stay informed and be well!
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