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Disseminated tuberculosis associated with ruxolitinib

Leukemia volume 28, pages 1750–1751 (2014)Cite this article

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A 62-year-old man who emigrated from Vietnam to the United States 18 years prior was diagnosed with JAK2 V617F-positive primary myelofibrosis (PMF) and initiated on treatment with the JAK1/2 inhibitor ruxolitinib 20 mg twice daily for severe constitutional symptoms and massive splenomegaly. After 7 weeks of therapy, the patient’s splenomegaly improved from 21 to 14 cm below the costal margin, but he continued to experience fevers, night sweats and anorexia. Two weeks later, the patient was hospitalized with high fever, abdominal pain, nausea, vomiting and diarrhea. Ruxolitinib was held on admission.

Computed tomography (CT) of the abdomen identified new low attenuation retroperitoneal and gastrohepatic lymphadenopathy. Positron emission tomography revealed markedly hypermetabolic right supraclavicular, mediastinal, portacaval and retroperitoneal lymphadenopathy. Core needle biopsy of a supraclavicular lymph node revealed only necrotic tissue. A bone marrow biopsy showed stable myelofibrosis without increased blasts. Cultures were not obtained from these specimens.

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Authors and Affiliations

  1. Division of Hematology, Washington University School of Medicine, St Louis, MO, USA

    R K Hopman & S T Oh

  2. Division of Infectious Diseases, Washington University School of Medicine, St Louis, MO, USA

    S J Lawrence

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  1. R K Hopman
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  2. S J Lawrence
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  3. S T Oh
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Correspondence to S T Oh.

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Hopman, R., Lawrence, S. & Oh, S. Disseminated tuberculosis associated with ruxolitinib. Leukemia 28, 1750–1751 (2014). https://doi.org/10.1038/leu.2014.104

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