{"doi":"10.1016/j.bneo.2025.100159","title":"Second malignancies among older patients with classical myeloproliferative neoplasms treated with ruxolitinib","abstract":"Polycythemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF) are classical Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) associated with an increased risk of development of second malignancies (SM). The reasons for solid and lymphoid SM are unclear, but a therapy-related effect has been invoked. While an increased risk of non-melanoma skin cancers is associated with the use of ruxolitinib (RUX), its influence on the development of other forms of SM remains controversial. We conducted a retrospective cohort analysis to assess associations between RUX and SM among older patients diagnosed with MPN from 2012-2019 in the Surveillance, Epidemiology, and End Results Medicare-linked database. We identified 6043 patients (2396 PV, 2944 ET, 703 MF) with median age of 76 (interquartile range [IQR]: 71-82) years. After a median follow-up of 3.66 (IQR: 2.25-5.17) years and 3.02 (IQR: 1.84-4.75) years for 513 RUX-users and 5530 non-users, respectively, 469 patients developed a SM: 383 solid and 86 lymphoid. In the multivariable proportional sub-distribution hazard regression model with death as a competing risk, the risk of developing any SM did not differ by RUX use status (hazard ratio [HR]= 0.96, 95% confidence interval [CI]: 0.65-1.42, p=0.84) nor proportion of days covered by RUX (every 10% increase: HR=1.00, 95% CI: 0.96-1.05, p=0.95). RUX exposure did not impact the risk of solid SM (HR=0.77, 95% CI: 0.48-1.23, p=0.27) or lymphoid SM (HR=1.73, 95% CI: 0.79-3.80, p=0.17). Our results suggest that the use of RUX does not increase the risk of SM in older patients with MPN.","journal":"Blood Neoplasia","year":2025,"id":572720,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9534,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1303348,"name":"Jessica M. Stempel","orcid":"0000-0001-9162-0579","position":1,"is_corresponding":false},{"id":284242,"name":"Rory M. Shallis","orcid":"0000-0002-8542-2944","position":2,"is_corresponding":false},{"id":233540,"name":"Scott F. Huntington","orcid":"0000-0001-7071-6475","position":3,"is_corresponding":false},{"id":280996,"name":"Amer M. Zeidan","orcid":"0000-0001-7017-8160","position":4,"is_corresponding":false},{"id":106676,"name":"Natalia Neparidze","orcid":"0000-0001-9038-077X","position":5,"is_corresponding":false},{"id":1479314,"name":"Mengyang Di","orcid":"0000-0001-6165-2617","position":6,"is_corresponding":false},{"id":280995,"name":"Jan Philipp Bewersdorf","orcid":"0000-0003-3352-0902","position":7,"is_corresponding":false},{"id":497378,"name":"Lourdes Mendez","orcid":"0000-0002-5922-2877","position":8,"is_corresponding":false},{"id":1208707,"name":"Xiaomei Ma","orcid":"0000-0001-8156-8404","position":9,"is_corresponding":false},{"id":292996,"name":"Nikolai A. Podoltsev","orcid":"0000-0002-3657-778X","position":10,"is_corresponding":false},{"id":282261,"name":"Rong Wang","orcid":"0000-0002-2169-4174","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T02:57:27.876396Z","pmid":"41216598","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}