[ Inglés] Predicting Progression in ET and PV: Updates From ASH 2017

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Topics include: Treatments and Understanding

What were the updates in essential thrombocythemia (ET) and polycythemia vera (PV) at the 2017 American Society of Hematology (ASH) annual meeting?  MPN experts, including Dr. Mark Heaney from Columbia University Medical Center, and Dr. Ruben Mesa from the UT Health San Antonio Cancer Center, share the latest news on identifying unique mutations, prognostic scoring, and choosing a treatment plan that’s compatible with your condition. Watch now to get the most recent updates on ET and PV care.

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

Mark, I want to speak a little bit with you about our patients who have PV. And you were mentioning about interferon, that could be helpful there. And also some with ET. Any news there beyond the interferon that you wanted to bring up?

Dr. Heaney:         

Well, there’s some data about hydroxyurea (Hydrea) and when to start it and whether patients do better if they start hydroxyurea earlier in their disease course, or whether it might be okay for them to wait. I think that some of the data that was presented at the meeting suggests that for patients who don’t have early complications of their disease, that holding off on hydroxyurea doesn’t lead them to miss potential therapeutic benefit.

Andrew Schorr:

Okay. Now one of the things that people with ET and PV worry about is progression. Where are we now with our understanding of when you might move from one to another or not?

Dr. Heaney:         

Well, I think that we have many more risk models of how the diseases might evolve, and I think that they’ve been enriched by a lot of the new molecular genetic data that has accumulated over just the last several years.

Some of the models have added to established models, such as the DIPSS or the DIPSS plus. Some of them are novel models.

I think now there are enough potential models, so we have a choice, and it’s hard to know which model might be the most accurate.

Andrew Schorr:

Do you have a comment on that, Ruben? You’ve been involved I think in one of the models and I think you were involved in the NCCN Guidelines as well, if I have that right? So, tell us—people want to know how do we know what my version of the disease is, or how it might change.

Dr. Mesa:               

Sure. So probably two different complementary concepts. One is the issue of really trying to figure out, or predict, how an individual patient’s disease is going to behave.

Because it particular, in the setting of myelofibrosis—you know well from the MPN community—there are individuals that have myelofibrosis for many years, even decades, and others that have a disease that can be life-threatening even in a short amount of time.

 

I would say there are so many of these scores, you almost need a playbook to follow them.

 

I think the key is that there are several themes in there, and they’re evolving. And they’re a great resource for clinicians. They probably, still in 2017, make the biggest impact in terms of the decision around bone marrow transplant. Up to this point, they’ve not had a big impact in terms of, do I choose ruxolitinib (Jakafi)? Do I choose hydroxyurea? Do I choose aspirin? The impact there has been much less.

But from a patient’s perspective, the things that those scores really look at are really trying to quantify the burden of the disease, both the things that are aware to you—some things such as age, things such as symptoms, blood counts—but also things that are hidden, such as genetic changes, both whether they’re in the chromosomes or very specific mutations.

So, it’s very much an evolving science, and it is being used to try to help, in particular, select who might be a candidate for transplant.

So, the latest variant of this—it was presented at this meeting—specifically looked at individuals in which transplant might be a consideration. So, specifically individuals with myelofibrosis under the age of 70—really using that as a key decision point.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on February 2, 2018