Hematology 2015, the American Society of Hematology Education program book— published in connection with the 57th Annual Meeting in Orlando, Florida — included a comprehensive review of therapeutic approaches to myelofibrosis by John Mascarenhas, Tisch Cancer Institute, Icahn School of Medicine, Mount Sinai.
To make this near encyclopedic review of therapeutic options and work in progress available to clinicians and patients, The MPN Quarterly Journal reproduces the paper in full.
For a readable version of the full paper appearing in Blood. click Here for the PDF.
Major sections and tables are:
Refining risk stratification in MF
A brief update on JAK2 inhibitors in MF
Non-JAK2 inhibitor therapy in MF
Focus on combination therapy in MF
Evaluating approaches to accelerated/blast phase MPN
Evaluating current HSCT clinical trial approaches in myelofibrosis
Role of HSCT in MF
Table 1. JAK2 inhibitors tested in clinical trials in patients with myelofibrosis
Table 2. Novel non-JAK2 inhibitors in clinical trials for patients with myelofibrosis
Table 3. Double- and triple-combination therapy trials in chronic and advanced phases of myelofibrosis
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Thankyou .what would the intervention be.i still don’t really understand the whatch and wait I would have thought that he would be getting some sort of treatment due to enlarged spleen and fibres growing in the bone marrow he has already had mutiple mini strokes phnemona a heart attach and has factor v laden and was only digonosed last August but said it had stemed from when he had the strokes back in 2007 als has deep vien thrombosis would you put this as a high risk category.
How do you no if you have an advanced stage of mf and what does whatch and wait meen.
From a practical perspective, Kaye, an advancing stage of MF is usually signaled by the way you feel and a likely uncomfortable swelling of your spleen. A cinical examination by your hematologists and a bone marrow biopsy can confirm progression. There are several scales commonly used scales to assist your hematologist in determining your level of MF, one being the IPSs or International Prognostic Scoring System (IPSS) for PMF,
“….the initial features independently associated with a poor prognosis were an age older than 65 years, the presence of constitutional symptoms, hemoglobin 25×109/L and the presence of blasts in the peripheral blood.
These prognostic factors formed the basis for four risk groups with clear-cut, non-overlapping survival curves: no factors (low risk), one factor (intermediate risk-1), two factors (intermediate risk-2) or three or more factors (high risk)”
Watch and Wait refers to deferring treatment and keeping an eye on your blood counts and clinical symptoms in case the need arises to intervene