CASE SUMMARY
A 68-year-old woman presented to her physician with symptoms of mild fatigue. Her spleen was palpable 6-7 cm below the left costal margin, but she had no known comorbidities. Next-generation sequencing revealed a JAK2 V617F mutation, and her karyotype was46XX. A bone marrow biopsy showed megakaryocyte proliferation and atypia with evidence of reticulin fibrosis, and a blood smear was positive for leukoerythroblastosis.
Her laboratory values also led to a diagnosis of primary myelofibrosis (MF). Risk stratification based on the dynamic international prognostic scoring system gave her a score of intermediate-1, and based on the mutation-enhanced international prognostic score system for transplantation-age she was also determined to be at intermediate risk.
DISCUSSION QUESTIONS
- Did the overall survival data from the COMFORT-I trial (NCT00952289) and COMFORT-II trial (NCT00934544) impact the way you manage patients with MF?
- How do you monitor and manage anemia in patients with primary MF prior to starting Janus kinase (JAK) inhibitor therapy?