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Intern Med. 2018 May 1;57(9):1297-1300. doi: 10.2169/internalmedicine.9165-17. Epub 2017 Dec 27.

Fatal Disseminated Tuberculosis during Treatment with Ruxolitinib Plus Prednisolone in a Patient with Primary Myelofibrosis: A Case Report and Review of the Literature.

Author information

1
Department of Hematology, Iizuka Hospital, Japan.
2
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Japan.
3
Department of Clinical Research Institute, National Kyushu Cancer Center, National Hospital Organization, Japan.

Abstract

A 73-year-old man with primary myelofibrosis (PMF) was being treated with hydroxyurea, which was changed to ruxolitinib treatment because of worsening constitutional symptoms. Although ruxolitinib rapidly induced relief, he developed a high-grade fever. A comprehensive fever work-up found no apparent cause of the fever, except for PMF. Therefore, we increased the dose of ruxolitinib and added prednisolone, which was gradually withdrawn with resolution of the fever. However, the patient subsequently developed disseminated tuberculosis and died eight months after initiation of ruxolitinib. Our case highlights the importance of assessing and monitoring the immune status of patients receiving ruxolitinib.

KEYWORDS:

disseminated tuberculosis; primary myelofibrosis; ruxolitinib

PMID:
29279479
PMCID:
PMC5980814
DOI:
10.2169/internalmedicine.9165-17
[Indexed for MEDLINE]
Free PMC Article

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