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A Journey Through JAK Inhibitors for the Treatment of Myeloproliferative Diseases

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Abstract

Purpose of Review

Chronic myeloproliferative neoplasms (MPN) represent a group of diseases characterised by constitutive activation of the JAK/STAT pathway in a clonal myeloid precursor. The therapeutic approach aims to treat the symptom burden (headache, itching, debilitation), splenomegaly, slow down the fibrotic proliferation in the bone marrow and reduce the risk of thrombosis/bleeding whilst avoiding leukaemic transformation.

Recent Findings

In recent years, the advent of JAK inhibitors (JAKi) has significantly broadened treatment options for these patients. In myelofibrosis, symptom control and splenomegaly reduction can improve quality of life with improved overall survival, not impacting progression into acute leukaemia. Several JAKi are available and used worldwide, and combination approaches are now being explored.

Summary

In this chapter, we review the approved JAKi, highlighting its strengths, exploring potential guidelines in choosing which one to use and reasoning towards future perspectives, where the combinations of therapies seem to promise the best results.

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Authors and Affiliations

  1. Department of Haematology, Guy’s and St Thomas’ NHS Foundation Trust, London, SE1 9RT, UK

    Andrea Duminuco, Elena Torre & Claire Harrison

  2. Haematology with BMT Unit, A.O.U. Policlinico “G.Rodolico-San Marco”, Catania, Italy

    Andrea Duminuco & Giuseppe A. Palumbo

  3. Clinica di Ematologia, Università Politecnica delle Marche, Ancona, Italy

    Elena Torre

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Correspondence to Claire Harrison.

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AD received personal fees from BMS, Celgene and EusaPharma.

GAP received honoraria from AbbVie, AOP, AstraZeneca, BMS, Celgene, GSK, Incyte, Janssen and Novartis.

CH reports research funding from Celgene, Constellation and Novartis and declares an advisory role for AbbVie, AOP, BMS, Celgene, CTI, IMAGO, Novartis, Galacteo, Geron, Gilead, Janssen, Keros, Promedior, Roche, Shire and Sierra.

ET declares no potential conflicts of interest.

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Duminuco, A., Torre, E., Palumbo, G.A. et al. A Journey Through JAK Inhibitors for the Treatment of Myeloproliferative Diseases. Curr Hematol Malig Rep 18, 176–189 (2023). https://doi.org/10.1007/s11899-023-00702-x

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