March 2025
Tag Archives: myeloproliferative neoplasms
Dr Bhat on the Influence of MPN Risk Stratification on Treatment Decision-Making
March 20, 2025
Author(s): Seema A. Bhat, MD
Fact checked by: Ashling Wahner, Courtney Flaherty
Seema A. Bhat, MD, a hematologist at The Ohio State University Comprehensive Cancer Center—James; as well as an assistant professor in the Department of Internal Medicine in the Division of Hematology at The Ohio State University, discusses the importance of risk stratification for navigating treatment selection for patients with myeloproliferative neoplasms (MPNs).
Stratifying patients with MPNs into appropriate risk groups is crucial for treatment decision-making, as patients’ individual risk factors strongly factor into selection, Bhat says. Typically, patients with low-risk disease will receive treatments directed at symptom management, whereas cytoreductive agents like hydroxyurea, as well as targeted therapies like JAK inhibitors, are considered for patients with high-risk disease, she explains. Furthermore, allogeneic stem cell transplantation may be a curative treatment option for patients with very high–risk MPNs, she notes.
The revised IPSET Thrombosis Score is used for essential thrombocythemia (ET) risk stratification. Patients are considered to have low-risk polycythemia vera (PV) if they are younger than 60 years of age and have no history of thrombosis; patients are considered to have high-risk PV if they are older than 60 years of age and/or have a thrombosis history.
Four JAK inhibitors are FDA approved for the treatment of patients with MPNs. Ruxolitinib (Jakafi) is indicated for adult patients with intermediate- or high-risk myelofibrosis, including primary myelofibrosis and secondary (post-PV or post-ET) myelofibrosis; as well as adult patients with PV who have had an inadequate response or are intolerant to hydroxyurea. Fedratinib (Inrebic) is approved for adult patients with intermediate-2 or high-risk primary or secondary myelofibrosis. Pacritinib (Vonjo) is indicated for use in adult patients with intermediate- or high-risk primary or secondary myelofibrosis with a platelet count below 50 × 109 /L. Finally, momelotinib (Ojjaara) is approved for adult patients with intermediate- or high-risk primary or secondary myelofibrosis with anemia.
Safety and Efficacy of Busulphan Based on Dosing Patterns in the Real‐World Management of Myeloproliferative Neoplasms
March 2025
Abstract
Myeloproliferative neoplasms (MPNs), such as polycythaemia vera (PV), essential thrombocythemia (ET) and myelofibrosis (MF), are primarily treated by managing blood counts to reduce the thrombotic risk using cytoreductive agents. Busulphan, an oral alkylating agent, has been historically used for MPN management due to its myelosuppressive effects, but concerns about its risk of leukaemic transformation have limited its use.
Topics of Interest in Women With Myeloproliferative Neoplasms
March 2025
Natasha Szuber, Paola Guglielmelli, Naseema Gangat
Abstract
Risk for Specific Hematologic Cancers Down With GLP-1 Receptor Agonist Use in T2DM
Publish Date
HealthDay News — For patients with type 2 diabetes (T2D), glucagon-like peptide-1 receptor agonist (GLP-1 RA) use is associated with a reduced risk for developing hematologic cancers compared with insulin and metformin use, according to a research letter published online March 6 in JAMA Network Open.
Omer S. Ashruf, from Northeast Ohio Medical University in Rootstown, and colleagues conducted a retrospective cohort study to compare the risks for hematologic cancers in patients with T2D treated with a GLP-1 RA versus metformin and insulin. The study included patients with T2D prescribed a GLP-1 RA, insulin, or metformin between April 30, 2005, and Oct. 31, 2023 (51,617; 611,115; and 938,602 patients, respectively). Groups were independently matched using a nearest neighbor greedy matching algorithm; 47,716 patients were included in the GLP-1 RA-insulin analysis and 50,590 were included in the GLP-1 RA-metformin analysis.
The researchers found that GLP-1 RA use was associated with significantly lower risks for of myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN) compared with metformin (hazard ratios, 0.61 and 0.67, respectively). No significant difference was seen in the risk for any other hematologic cancer. GLP-1 RA use was associated with significantly lower risks for myeloid leukemia, lymphoid leukemia, non-Hodgkin lymphoma, MDS, MPN, monoclonal gammopathy, multiple myeloma, and amyloidosis compared with insulin (hazard ratios, 0.39, 0.45, 0.42, 0.19, 0.50, 0.68, 0.49, and 0.52, respectively). GLP-1 RA use was associated with a 54 percent lower risk than that seen with insulin across all hematologic cancers.
JAK Inhibitors Reduce Thromboembolic Risk in Myeloproliferative Neoplasm Therapy
March 11, 2025
Author(s): Alex Biese
Fact checked by: Ryan Scott
Treatment with Janus kinase inhibitors (JAKis) has been found to be associated with a reduction in risk of thromboembolic events among patients with myeloproliferative neoplasms (MPNs), according to research findings.
These findings were published in eJHaem, and are driven by observations of treatment with Jakafi (ruxolitinib) for patients with polycythemia vera and myelofibrosis, researchers noted.
“In this meta-analysis, JAKi [used for] MPN [treatment] was associated with a reduced risk of thromboembolic events compared [with] control, primarily driven by studies of [Jakafi] in polycythemia vera and myelofibrosis,” first study author Roberta Dunn and colleagues wrote in the study. “JAKi treatment was not associated with an increased risk of [major adverse cardiovascular events] or hypertension, adding to the existing body of evidence demonstrating the safety of JAKi in the treatment of MPNs. Further prospective clinical trials are warranted to confirm these findings and characterize the cardiovascular profile of other JAKis in all types of MPNs.”
Dunn is a medical student at the School of Medical Education, King’s College London, as well as a student researcher at Guy’s and St Thomas’ NHS Foundation Trust, in the United Kingdom.
MPNs, according to the Cleveland Clinic, are rare blood cancers that involve the patient’s body making too many red blood cells, white blood cells or platelets. JAKis, as explained by the National Cancer Institute, block the actions of enzymes which control cell signaling and growth, the number of blood cells and platelets made in the bone marrow, inflammation, and immune cell activity. Blocking these enzymes may help prevent abnormal blood cells or cancer cells from growing.
A Toolkit for Healthcare Transition for Adolescents With Classical Myeloproliferative Neoplasms
March 2025
Abstract
Classical myeloproliferative neoplasms (MPNs) are being identified more frequently in adolescents. There is no guidance on the healthcare transition of young MPN patients from pediatric to adult medicine. Therefore, we convened an international panel of experts in both pediatric and adult MPN care to develop three tools to facilitate high-quality healthcare transition: a physician education tool, a transition readiness assessment tool, and a consensus statement of practice recommendations to ensure a more seamless transition in the care adolescents receive. These tools can help ensure a better healthcare transition for young patients. The next steps include evaluating the readiness assessment tool with adolescent patients.
The role of psychosocial adjustment in the quality of life of patients with myeloproliferative neoplasms
March 7, 2025
A.A.M. Eppingbroek, L. Lechner, E.C. Bakker, M.D. Niijkamp, M.A. de Witte, C.A.W. Bolman
Abstract
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Hematologic Cancers Among Patients With Type 2 Diabetes Prescribed GLP-1 Receptor Agonists
March 6, 2025
Omer S. Ashruf, BS1Jasmin Hundal, MD, MS, MPH2Ali Mushtaq, MD3; et al
Type 2 diabetes (T2D) and obesity have been identified as independent risk factors for various cancers, including hematologic cancers.1 Glucagon-like peptide–1 receptor agonists (GLP-1RA) have emerged as an effective treatment, offering glycemic control, weight reduction,2 and immune modulation,3 and are associated with lower cancer risk, specifically solid tumors.4 However, the association of GLP-1RA with hematologic cancers remains unexplored. This study aims to compare the risks of hematologic cancers in patients with T2D treated with GLP-1RA compared with metformin and insulin.
Patients With MF May Benefit From Interdisciplinary Care and Personalized Treatment
A new position paper combining insights from a panel discussion of German experts about the diagnosis and treatment of patients with myelofibrosis (MF) was published in the scientific journal Annals of Hematology. The paper highlights the need for an interdisciplinary approach, adherence to updated World Health Organization (WHO) and the International Consensus Classification (ICC) diagnostic criteria, and personalized treatment approaches for each patient.
The team of authors led by Florian H. Heidel, MD, from the Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation at Hannover Medical School in Hannover, Germany said that by addressing diagnostic challenges and therapeutic nuances, the paper aims to improve outcomes and quality of life for patients in the prefibrotic phase of primary MF.
The panel discussions were grouped under 3 main areas which were:
- The definition and diagnosis of prefibrotic primary MF, its clinical characteristics, and how they separate from other subentities of myeloproliferative neoplasms.
- Whether essential thrombocythemia and prefibrotic primary MF are distinguishable entities or part of a continuous spectrum.
- The therapeutic options and how Janus kinase (JAK)-inhibitor therapy ranks among therapies of prefibrotic primary MF.
The relevant aspects of the panel discussion for each area were then outlined in detail.
It was concluded that profibrotic primary MF has unique morphological, clinical, and molecular characteristics that distinguish it from essential thrombocythemia and overt primary MF and that the diagnostic process relies on the histological analysis of the bone marrow, the identification of genetic mutations, and the exclusion of other myeloid neoplasms.