Pulmonary Tuberculosis Reactivation and CNS Involvement Following Treatment of Myelofibrosis with Ruxolitinib: Case Report and Review of the Literature of Incidence in Myeloproliferative Neoplasms

A 69-year-old man with primary myelofibrosis was being treated with ruxolitinib for worsening constitutional symptoms. While ruxolitinib provided rapid symptom relief, he developed hemoptysis and changes to chest imaging. Comprehensive evaluation was diagnostic of mycobacterium tuberculosis with eventual progression to the central nervous system. Here we report the successful treatment of tuberculosis reactivation and describe the incidence of mycobacterium tuberculosis infection during treatment with ruxolitinib. Clinicians should consider risk of opportunistic infections when treating patients with myeloproliferative neoplasms with immunosuppressant medications such as ruxolitinib.

Keywords: myelofibrosis, myeloproliferative neoplasm, mycobacterium tuberculosis, ruxolitinib.