It’s your life.It’s your journey.It’s your
myelofibrosis (MF).
Diagnosis is just the beginning. Find out what defines your type of MF.
MF is a rare, progressive cancer caused by various changes (mutations) in the DNA of your bone marrow (the spongy tissue inside bones). These changes can disrupt how your body would normally produce healthy blood cells. Decreases in your red blood cell and platelet counts may be one of many signs that your MF at diagnosis might not be the MF you have today.
- Red blood cells carry oxygen to tissues throughout your body
- Platelets help your blood clot
- White blood cells help your body to fight infection
- Tiredness and/or weakness
- Shortness of breath
- Easy bleeding and/or bruising
Your healthcare team will monitor your blood cell counts over time to see if your MF is changing.
How do you know if your MF is changing?
Learning more about these signs can help you understand more about what makes your MF unique.
Why do cytopenias matter when discussing your MF?
Red blood cell and platelet counts can decrease over the course of MF—sometimes rapidly. These low blood cell counts are often called cytopenias, and you may hear your doctor refer to MF with low red blood cell and platelet counts as “cytopenic MF.”
Cytopenias may be caused by MF or by previous medications taken for MF. In early stages of MF, ~30% of people don’t have symptoms associated with cytopenias but symptoms may develop as MF progresses and blood cell counts drop.
What do red blood cell transfusions have to do with your MF?
If you need red blood cell transfusions more often during MF treatment, this may be a sign of worsening MF that’s worth discussing with your doctor. To determine if these transfusions are needed, your doctor may test your hemoglobin level (a protein in your red blood cells) to see if your body has fewer red blood cells than normal (anemia).
When your red blood cells drop low enough, you may have to get one or more transfusions to help quickly raise your red blood cell count and reduce symptoms of anemia (eg, more tired or weaker than usual). However, as the impact of each transfusion decreases over time, you may need transfusions more frequently over the course of your disease.
If your MF treatment dose is lowered, could it be a sign of changes in your MF?
Your MF treatment dose may be based on your platelet counts. If your platelet counts drop, your doctor may lower or otherwise change the dose of your MF treatment. In certain situations, those lower platelet counts may be caused by your MF treatment and your doctor may talk to you about VONJO.
Where do symptoms of spleen enlargement come from in MF?
When your bone marrow isn’t working properly, the spleen works harder than normal to try to replace damaged blood cells with new ones. This causes the spleen to grow, which puts pressure on nearby organs. Symptoms can include early feelings of fullness when eating, abdominal discomfort, and pain under the ribs on the left side.
When you are being treated for MF, your doctor will check your spleen size by feeling your upper abdominal area or by using imaging tests (such as computerized tomography [CT/CAT scan], magnetic resonance imaging [MRI], or ultrasound) for more accuracy. Symptoms of spleen growth may be telling you how you’re responding to treatment.
What can new or worsening symptoms tell you about your MF?
Since MF is a progressive disease, it's important to keep track of your symptoms and tell your doctor if they worsen or become more concerning to you.
Think about how those worsening symptoms may be changing your daily routine. Do they hold you back from activities you enjoy, such as taking walks, sharing meals with friends, or spending time with your family?
If you're concerned about the changes in your symptoms, talk with your doctor. These changes could be a sign that your MF is evolving.
Throughout your treatment for MF, you should ask yourself:
- Am I feeling more symptoms or feeling worse, despite my treatment?
- Am I feeling more tired or weaker than usual?
- Am I noticing unusual bruising and/or bleeding?
- Do I feel symptoms of spleen enlargement (eg, early fullness, abdominal discomfort, pain under left ribs)?
Taking notes to share with your doctor can help you discuss how your symptoms have changed over the course of your MF treatment. Always talk to your doctor if you have any signs or symptoms that bother you or won’t go away.
If your MF has changed since diagnosis, why hasn’t your treatment? It may be time for VONJO.
What is VONJO® (pacritinib) approved for?
VONJO is a prescription medicine used to treat adults with certain types of myelofibrosis (MF) who have a platelet count below 50 × 109/L.
It is not known if VONJO is safe and effective in children.
This indication is approved under accelerated approval based on spleen volume reduction. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).
Important Safety Information
VONJO can cause serious side effects, including:
Bleeding. VONJO may cause severe bleeding, which can be serious and, in some cases, may lead to death. Avoid taking VONJO if you are bleeding. If you develop bleeding, stop VONJO and call your healthcare provider. Your healthcare provider will do a blood test to check your blood cell counts before you start VONJO and regularly during your treatment with VONJO. Tell your healthcare provider right away if you develop any of these symptoms: unusual bleeding, bruising, and fever. You will need to stop taking VONJO 7 days before any planned surgery or invasive procedure (such as a heart catheterization, stent placement in a coronary artery in your heart, or a procedure for varicose veins). Your healthcare provider should tell you when you can start taking VONJO again.
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US-PAC-2200123 05/2023
What is VONJO® (pacritinib) approved for?
VONJO is a prescription medicine used to treat adults with certain types of myelofibrosis (MF) who have a platelet count below 50 × 109/L.
It is not known if VONJO is safe and effective in children.
This indication is approved under accelerated approval based on spleen volume reduction. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).
Important Safety Information
VONJO can cause serious side effects, including:
Bleeding. VONJO may cause severe bleeding, which can be serious and, in some cases, may lead to death. Avoid taking VONJO if you are bleeding. If you develop bleeding, stop VONJO and call your healthcare provider. Your healthcare provider will do a blood test to check your blood cell counts before you start VONJO and regularly during your treatment with VONJO. Tell your healthcare provider right away if you develop any of these symptoms: unusual bleeding, bruising, and fever. You will need to stop taking VONJO 7 days before any planned surgery or invasive procedure (such as a heart catheterization, stent placement in a coronary artery in your heart, or a procedure for varicose veins). Your healthcare provider should tell you when you can start taking VONJO again.
Diarrhea. Diarrhea is common with VONJO, but can also be severe, and cause loss of too much body fluid (dehydration). Tell your healthcare provider if you have diarrhea and follow instructions for what to do to help treat diarrhea. Drink plenty of fluids to help prevent dehydration. Your healthcare provider may change your dose of VONJO if you have severe diarrhea.
If you notice any change in how often you have bowel movements, if they become softer or you have diarrhea, start taking an antidiarrheal medicine (for example, loperamide) as soon as you notice changes, as directed by your healthcare provider.
Worsening low platelet counts. Your healthcare provider will do blood tests to check your blood counts before you start taking VONJO and during treatment with VONJO.
Changes in the electrical activity of your heart called QTc prolongation. QTc prolongation can cause irregular heartbeats that can be life-threatening. Your healthcare provider will check the electrical activity of your heart with a test called an electrocardiogram (ECG) before you start VONJO and during treatment with VONJO, as needed. If you have a history of low blood potassium, it is important that you get your blood tests done as ordered by your healthcare provider to monitor your body salts (electrolytes) in your blood. Tell your healthcare provider right away if you feel dizzy, lightheaded, or faint.
Increased risk of major cardiovascular events such as heart attack, stroke, or death in people who have cardiovascular risk factors and who are current or past smokers have happened in some people taking another Janus associated kinase (JAK) inhibitor to treat rheumatoid arthritis. Get emergency help right away if you have any symptoms of a heart attack or stroke while taking VONJO, including: discomfort in the center of your chest that lasts for more than a few minutes, or that goes away and comes back; severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw; pain or discomfort in your arms, back, neck, jaw, or stomach; shortness of breath with or without chest discomfort; breaking out in a cold sweat; nausea or vomiting; feeling lightheaded; weakness in one part or on one side of your body; or slurred speech.
Increased risk of blood clots. Blood clots in the veins of your legs (deep vein thrombosis, DVT) or lungs (pulmonary embolism, PE) have happened in some people taking another JAK inhibitor and may be life-threatening. Tell your healthcare provider if you have had blood clots in the veins of your legs or lungs in the past. Tell your healthcare provider right away if you have any signs and symptoms of blood clots during treatment with VONJO, including: swelling, pain, or tenderness in one or both legs; sudden, unexplained chest pain; or shortness of breath/difficulty breathing.
Possible increased risk of new (secondary) cancers. People who take another JAK inhibitor for rheumatoid arthritis have an increased risk of new (secondary) cancers, including lymphoma and other cancers, except non-melanoma skin cancer. The risk of new cancers is further increased in people who smoke or who smoked in the past.
Risk of infection. People who have certain blood cancers and take another JAK inhibitor have an increased risk of serious infections. Infections are common with VONJO, but people who take VONJO may also develop serious infections, including bacterial, mycobacterial, fungal, and viral infections. If you have a serious infection, your healthcare provider may not start you on VONJO until your infection is gone. Your healthcare provider will monitor you and treat you for any infections that you get during treatment with VONJO. Tell your healthcare provider right away if you develop any of the following symptoms of infection: chills, aches, fever, nausea, vomiting, weakness, painful skin rash, or blisters.
The most common side effects of VONJO include: nausea, vomiting, low red blood cell count (anemia), and swelling of your ankles, legs, and feet.
VONJO may affect fertility in males. You may have problems fathering a child. Talk to your healthcare provider if this is a concern for you.
These are not all the possible side effects with VONJO. Call your doctor for medical advice about side effects.
- smoke or were a smoker in the past
- have had previous medical conditions such as any other cancers, blood clot, heart attack, other heart problems, stroke, infection, diarrhea, commonly loose stools, nausea, vomiting, liver problems, or kidney problems
- have active bleeding, have had severe bleeding, or plan to have surgery. You should stop taking VONJO 7 days before any planned surgery or invasive procedures (such as a heart catheterization, stent placement in a coronary artery in your heart, or a procedure for varicose veins)
- are pregnant, plan to become pregnant, are breastfeeding, or plan to breastfeed. It is not known if VONJO will harm your unborn baby or if it passes into breast milk. You should not breastfeed during treatment and for 2 weeks after your last dose of VONJO
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking VONJO with certain other medicines may affect the amount of VONJO in your blood and may increase your risk of side effects or affect how well VONJO works. Know the medicines you take. Keep a list of the medicines you take to show your healthcare provider and pharmacist when you get a new medicine.
Take VONJO exactly as your healthcare provider tells you to take it. Do not change your dose or stop taking VONJO without first talking to your healthcare provider. If you take other kinase inhibitors, carefully follow your healthcare provider’s instructions about how to slowly decrease (taper) your dose and stop the other kinase inhibitor medicines before you begin taking VONJO. Take VONJO two times daily, with or without food, at about the same time of day. Swallow VONJO capsules whole—do not open, break, or chew capsules. If you take too much VONJO, call your healthcare provider or go to the nearest emergency room right away and take your bottle of VONJO with you. If you miss a dose, skip it, and take your next dose at your regular time—do not take 2 doses at the same time to make up for the missed dose. Your healthcare provider may change your dose or how often you take it, temporarily stop, or permanently stop treatment if you have certain side effects.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see full Prescribing Information.
