ASH 2023: Cardiovascular Complications and Myelofibrosis

Patients with myelofibrosis (MF) are at higher risk for developing cardiovascular complications, including heart failure. Pulmonary hypertension is also common for those with MF. Heart problems occur in 66% of all myelofibrosis patients. Some of the conditions that can develop may be:

• Heart attacks (a condition in which blood flow to the heart is suddenly blocked, causing damage to the heart muscle).
• Stroke (a condition in which a blood vessel carrying blood and oxygen to the brain is blocked or bursts).
• Pulmonary embolism (a blood clot that blocks arteries in the lungs).
• Pulmonary hypertension (high blood pressure within the blood vessels that connect the heart and the lungs).
• Arrhythmias (changes in the heart’s rhythm).

The Use Of Ruxolitinib

At the 2023 American Society of Hematology (ASH) conference, a study was presented on cardiovascular-related mortality risk with outcomes based on the use (and non-use) of ruxolitinib. This medication works by blocking the signals that cause cancer cells to multiply which helps to stop the spread of cancer throughout the body.

Ruxolitinib was first introduced for use with myelofibrosis patients in 2011 and has since shown improved survival. Yet, studies have shown that with the administration of ruxolitinib, cardiovascular failure is still the third leading cause of death for myelofibrosis patients. 

The study presented at ASH 2023 compared patients who were administered ruxolitinib and those who were not. 4,509 patients were studied with the median age of 65 years old. Some of the study statistics noted:

• More patients were alive who received ruxolitinib (49.6%) compared to those who did not receive ruxolitinib (16.6%)
• Hypertension and cerebrovascular disease rates were higher among the non-ruxolitinib group of patients
• Cardiovascular mortality was reduced in patients who received ruxolitinib
• "Ruxolitinib may have had some mortality benefits from cardiovascular disease in myelofibrosis”.

Heart Health

Myelofibrosis can lead to anemia and can cause heart problems such as arrhythmia, an enlarged heart, or heart failure. There is no guarantee that a patient won’t develop a heart condition, but there are steps patients can take to help prevent complications:

• Healthy eating choices: more vegetables, fruit and whole grains. Foods that contain fiber, vitamins and minerals are most helpful
• Eat less saturated and trans fats (high-fat red meat, high-fat dairy products, processed foods and fast foods)
• Consume a low-salt diet.
• Limit alcohol and avoid smoking
• Engage in regular physical activity