Will the spleen stop enlarging after discontinuation of ruxolitinib?

Dec 02, 2025 Source: Cainiu Health

Dr. Sun Lianqing

Introduction

After discontinuation of ruxolitinib, the spleen may not enlarge if the disease remains stable. If splenomegaly was effectively controlled during ruxolitinib treatment, the underlying condition (such as myelofibrosis) is in a stable phase, and the drug is tapered and discontinued under physician guidance, the body may maintain control over the disease, and the spleen typically does not show significant enlargement. In some patients, spleen size can remain unchanged compared to pre-discontinuation levels.

Generally, after discontinuation of ruxolitinib, the spleen may not enlarge if the disease remains stable; however, if the condition relapses, splenomegaly may continue to progress. If there are any concerns, it is recommended to seek medical advice in advance. Detailed analysis is as follows:

If during ruxolitinib treatment spleen enlargement has been effectively controlled and the underlying disease (such as myelofibrosis) is in a stable phase, and if the drug is tapered and discontinued under physician guidance, the body may maintain control over the disease, and significant spleen enlargement typically does not occur. Some patients can maintain their pre-discontinuation spleen size.

However, if spleen control was inadequate during treatment or the underlying disease had not reached a stable state, abruptly stopping the medication or failing to taper according to medical advice may trigger disease relapse. Once the inhibitory effect of the drug is lost, the spleen may continue to enlarge, possibly accompanied by symptoms such as abdominal distension and fatigue. In severe cases, the treatment plan may need to be readjusted.

Discontinuation of ruxolitinib must strictly follow medical instructions—self-discontinuation is not advised. After stopping the drug, regular follow-up evaluations of spleen size and indicators of the underlying disease are essential. Any new symptoms should prompt immediate medical consultation to prevent disease progression.

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