Which other drugs are usually used alongside ruxolitinib when it's not having enough effect on its own?

[MCW22]

I've been on ruxolitinib for 4 years for my pv. My white count has always been stubbornly high. Consultant has always brushed it off saying it goes with the condition. My last blood test, everything is fine except now my whites have reached an all time high of 45. The consultant mentioned the possibility of introducing another drug but didn't say what. She said she would wait and see what my counts are at my next test in 8 weeks.I did wonder if the flu jab I had 2 weeks previously could have affected the results.

If I do end up having to take another drug alongside the ruxolitinib, what is it likely to be?

Carol.

[hunter5582]

I would not want to guess what med the doc may have in mind to combine with ruxolitinib. There has been some research into interferon-ruxolitinib combination therapy for PV. No way to know if that is what the doc has in mind.

Leukocytosis at 45 is very high. Not sure what you baseline is though. The short answer is that a vaccine could increase your WBCs. It is important to look at which WBCs are elevated to properly interpret what the numbers mean. This is a conversation that is best help with your MPN Specialist who knows your case history.

All the best.

[william-Indo]

My doctor gave me a combo of Jakafi and Pegasys, since Jakafi along can't work anymore, even in dose 40mg.

My blood work stable and even after the doses of both meds has reduce to minimal.

Hope this info may help.

Cheers

[ainslie]

What dose are you on and what are your other counts eg Hct, Hgb, platelets, is a dose increase an option, some docs add Pegasys for example

[MCW22 in reply to ainslie]

I'm waiting to receive the full print out of my latest blood test, but the hi lights I have been given so far are

wbc 45

hgb 11.1

plt 255

I currently take 4 x 5mg rux tablets a day. 2 in the morning and 2 in the evening.

I'm hoping the rise in whites is a reaction to the flu jab I had 2 weeks previously.

I also wondered about maybe a tiny increase in rux. I will just have to wait for the next test in 8 weeks to see what happens.

Carol

[ainslie in reply to MCW22]

Yes first maybe see what flu jab effect was. Possibly a slight increase in Rux but Hgb already lowish. I think we may have discussed this before but if whites stay up around that number I would say further investigation is maybe wise, I would “brush off” your consultants view that that level of whites is typical with PV when the other counts are not raised and on a good dose of Rux. I am speculating but it might be possible your whites are raised for a non MPN reason. If it was me I think I would be considering a second opinion from a MPN expert if no other reason can be found for raised whites.

[Leighcox85]

That would completely depend on your counts iam at the stage now that rux no longer works they moved me on to fedratinib but I had multiple infections then sepsis I had surgery wash out my hip joints and I was taken off fed and put back on rux I have low platelets so I have no options and stem cell is my only chance but with complications I have it makes it very dangerous for me there’s a few trials and many have been successful on fedratinib so they may try that option with you good luck