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Tacrolimus + ruxolitinib is an investigational combination regimen consisting of the small-molecule calcineurin inhibitor tacrolimus and the oral small-molecule Janus kinase 1 and 2 (JAK1/JAK2) inhibitor ruxolitinib. This combination is primarily evaluated as a graft-versus-host disease (GVHD) prophylaxis regimen in patients undergoing allogeneic hematopoietic stem cell transplantation (HCT), particularly those with myelofibrosis or other hematologic malignancies. Tacrolimus acts by blocking interleukin-2 (IL-2)-mediated T-cell activation and proliferation, while ruxolitinib targets the JAK-STAT pathway to suppress inflammatory cytokine signaling. The combination is typically administered alongside other agents, such as methotrexate or post-transplant cyclophosphamide, to reduce the incidence and severity of acute and chronic GVHD.
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