ArticleBiomarker research2025
Combinatorial BCL2/BCL2L1 expression predicts clinical response to ruxolitinib in myelofibrosis.
Article in Biomarker research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Megakaryocytes in myelofibrosis: mechanisms of fibrotic niche remodeling and therapeutic implications.Biomarker research · 2026Review
- Peptide nanoarchitectonics of biomimetic nanozyme synergistically inhibits smooth muscle cell proliferation and promotes endothelial repair to reduce poststenting complications.Journal of nanobiotechnology · 2026Article
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Authors and funding
7 authors.
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Abstract
Myelofibrosis is characterized by aberrant JAK/STAT signaling, with approved therapy including the JAK inhibitor ruxolitinib. Preclinical evidence implicates BCL-2 family proteins in MF pathogenesis and therapeutic response. Here, we evaluated baseline and on-treatment expression of BCL2, BCL2L1 (encoding BCL-xL), and MCL1 in 19 myelofibrosis patients receiving ruxolitinib. Quantitative PCR fold-change (FC) values, relative to healthy donors, revealed reduced baseline BCL2 (mean FC 0.15) and MCL1 (0.32) expression, with BCL2L1 showing a non-significant trend toward upregulation. Baseline BCL2 and BCL2L1 expression was significantly higher in patients achieving spleen response (responders; n = 7) compared to non-responders (BCL2: 0.30 vs 0.07, p = 0.0130; BCL2L1: 2.73 vs 0.52, p = 0.0096). Logistic regression confirmed both as independent predictors of response. We derived a combinatorial score (CS = FCBCL-2 * FCBCL2L1), which outperformed individual genes in response prediction, as confirmed in logistic regression analysis (OR, 7.5; p = 0.0028). ROC-defined cutoff (0.06) stratified patients by likelihood of response (OR 3.3, p = 0.0037). Longitudinal analysis showed no significant overall change in gene expression on ruxolitinib, but responders exhibited BCL2 down-regulation at loss of response (p = 0.0419). Overall, these preliminary findings suggest that BCL2 and BCL2L1 expression, individually and via a simple CS, predict response to ruxolitinib in myelofibrosis. While limited by small sample size and retrospective design, our data support prospective validation and exploration of BCL-2 pathway modulation as a therapeutic strategy.
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