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A retrospective real-world study of the current treatment pathways for myelofibrosis in the United Kingdom: the REALISM UK study

Authors: A J Mead, N M Butt, W Nagi, A Whiteway, S Kirkpatrick, C Rinaldi, C Roughley, S Ackroyd, J Ewing, P Neelakantan, M Garg, D Tucker, J Murphy, H Patel, R Bains, G Chiu, J Hickey, C Harrison, T C P Somervaille

Published: Therapeutic advances in hematology, 2022

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Background:

Myelofibrosis (MF) is a blood cancer associated with splenomegaly, blood count abnormalities, reduced life expectancy and high prevalence of disease-associated symptoms. Current treatment options for MF are diverse, with limited data on management strategies in real-world practice in the United Kingdom.

Methods:

The REALISM UK study was a multi-center, retrospective, non-interventional study, which documented the early management of patients with MF. The primary endpoint was the time from diagnosis to active treatment.

Discussion:

Two hundred patients were included (63% [n = 126/200] with primary MF; 37% [n = 74/200] with secondary MF). Symptoms and prognostic scores at diagnosis were poorly documented, with infrequent use of patient reported outcome measures. ‘Watch and wait’ was the first management strategy for 53.5% (n = 107/200) of patients, while the most commonly used active treatments were hydroxycarbamide and ruxolitinib. Only 5% of patients proceeded to allogeneic transplant. The median (IQR) time to first active treatment was 46 days (0–350); patients with higher risk disease were prescribed active treatment sooner.

Conclusion:

These results provide insight into real-world clinical practice for patients with MF in the United Kingdom. Despite the known high prevalence of disease-associated symptoms in MF, symptoms were poorly documented. Most patients were initially observed or received hydroxycarbamide, and ruxolitinib was used as first-line management strategy in only a minority of patients.