Therapeutic effect of thalidomide combined with ruxolitinib on treatment of patients with primary myelofibrosis

Wu Yongqiang; He Qiaoyu; Chen Jiefu; Tang Guang

doi:10.3969/j.issn.1672-8157.2025.06.024

Abstract：Objective To explore the clinical effect of thalidomide combined with ruxolitinib on treatment of patients with primary myelofibrosis.Methods A total of 71 patients with primary myelofibrosis admitted to Anyang District Hospital between March 2019 and March 2022 were enrolled in the study and randomly divided into two groups.The control group(36 cases)was treated with ruxolitinib and the experimental group(35 cases)was given thalidomide combined with ruxolitinib,with a treatment duration of 12 months.The clinical efficacy,changes in spleen size and degree of myelofibrosis,and the incidence of adverse reactions were observed in the two groups.Results After 12 months of treatment,the total effective rate of the experimental group was 91.43%(32/35),higher than 80.56%(29/36)of the control group,and there was no statistically significant difference(χ2=2.458,P=0.117).After treatment,the myeloproliferative neoplasms symptom assessment scale(MPN-10)scores decreased in the experimental group((15.77±4.68)points)and the control group((18.44±5.43)points),and there was a statistically significant difference(t=2.219,P<0.05).The proportion of MPN-10 scores with≥50%reduction in the experimental group was higher than that in the control group(71.43%vs 47.22%,χ2=4.321,P<0.05).After treatment,91.43%of patients in the experimental group and 86.11%of patients in the control group showed spleen size reduction.There were statistically significant differences in spleen length and spleen thickness between the two groups before and after treatment(all P<0.05).There was no statistically significant difference between the two groups after treatment(t=1.707,1.764,both P>0.05).The proportion of patients with improvement or stabilization in the degree of bone marrow fibrosis in the experimental group showed no statistically significant difference compared to the control group(91.43%vs 80.56%,χ2=0.952,P>0.05).The incidences of anemia and thrombocytopenia in the experimental group were 22.86%and 17.14%,lower than 61.11%and 50.00%in the control group(χ2=10.643,8.562,both P<0.05).There was no statistically significant difference in the overall incidence of adverse reactions between the two groups(45.71%(16/35)vs 66.67%(24/36);χ2=3.167,P>0.05).Conclusion Rux-olitinib in combination with thalidomide can synergistically improve myelofibrosis and clinical symptoms,and reduce the risk of anemia and thrombocytopenia,demonstrating favorable safety profile.