RUXOLITINIB TAB,ORAL
Clinical Criteria Summary
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Exclusion Criteria
- Active or uncontrolled infection
- Unmanageable drug-drug interaction
- End stage renal disease (CrCl < 15ml/min) not on dialysis
- Absolute Neutrophil Count (ANC) < 1000/mm3 and/or platelet count < 50,000/mm3 unless due to marrow involvement or associated with Duffy-null Associated Neutrophil Count (DANC)
- Lactating
Inclusion Criteria (Provider, Monitoring, & Performance Status)
- Care provided by a VA or VA Community Care hematology provider
- Goals of care and role of Palliative Care consult have been discussed and documented
- Eastern Cooperative Oncology Group performance status 0 - 3
- Baseline Complete Blood Count (CBC) and documentation of spleen length or volume (by palpation OR imaging)
- Repeat CBC 1 week after initiation of treatment, then every 2-4 weeks until dose stabilizes, then as clinically necessary
Indication/Diagnosis Requirements
- Diagnosis of intermediate or high-risk myelofibrosis (MF), including primary MF, post-polycythemia vera MF, post-essential thrombocythemia MF
- Diagnosis of polycythemia vera with an inadequate response or intolerance to hydroxyurea
Special Population Considerations
- For females who are breastfeeding: Manufacturer recommends discontinuing breastfeeding during treatment with ruxolitinib and for 2 weeks after stopping treatment.
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Indication/Context
- Graft Versus Host Disease (GVHD)
Exclusion Criteria
- Active or uncontrolled infection
- Unmanageable drug-drug interaction
- End-Stage Renal Disease (CrCl < 15ml/min) not on dialysis
- Absolute Neutrophil Count (ANC)
- Lactating
Inclusion Criteria
- Care provided by a VA or VA Community Care hematology provider
- Eastern Cooperative Oncology Group performance status 0-2
- Steroid-refractory (or dependent) acute Graft Versus Host Disease (GVHD) following allogeneic stem cell transplant
- Steroid-refractory chronic GVHD after >/= 1 line of therapy with progression, lack of response or steroid-intolerance
Additional Clinical Requirements
- For females who are breastfeeding: Manufacturer recommends discontinuing breastfeeding during treatment with ruxolitinib and for 2 weeks after stopping treatment.