Hematologic Malignancies

Myeloproliferative Neoplasms

Questions discussed in this category

For essential thrombocythemia with an indication for aspirin, would you defer therapy if they are on celecoxib?

How does triple-negative status influence your management of ET?

Is your management still guided primarily by risk stratification, or does the triple-negative status impact your decision-making about aspirin or cyto...

1 Answer available

What experience have you had with familial clustering of polycythemia vera?

Patient has a father and sister with both polycythemia vera with confirmed JAK2 V617F mutations. There is also suspicion for PV in a niece with pulmon...

1 Answer available

For patients with essential thrombocythemia already on prophylactic dose DOACs, do you defer starting aspirin?

2 Answers available

For patients with intermediate or lower risk essential thrombocythemia with plt >1000 but no symptoms, do you favor aspirin only therapy or aspirin and cytoreduction?

Recent data without increased cumulative incidence of bleeding in ET patients with plt >1000. Has your practice changed to use cytoreduction less f...

1 Answer available

Would you change therapy for a CML patient in hematologic remission on imatinib found with positive qualitative BCR-ABL1 for the p230 protein?

qPCR for BCR/ABL was negative. FISH remained positive.

1 Answer available

How do you decide between using ropeginterferon alfa-2b and peginterferon alfa-2a in MPN?

If a patient is unable to tolerate peginterferon, is there any reason to think they may do better with ropeginterferon?

1 Answer available

When do you consider cytoreduction in patients with Essential Thrombocytosis?

In a patient with no evidence of bleeding, do you use a platelet cutoff? Do you utilize genomic testing (eg CALR, MPL, JAK2, etc.) to decide on cytore...

1 Answer available

Under which circumstances would you prefer ropeginterferon over hydroxyurea for patients with Polycythemia Vera?

Ropeginterferon is now a preferred therapy for Polycythemia Vera (PV) as per a recent update to the NCCN guidelines.

1 Answer available

In which patients with essential thrombocythemia would you use ropeginterferon alfa-2b?

2 Answers available

For patients with essential thrombocythemia who develop venous thrombosis in the setting of elevated platelet counts, would you continue lifelong anticoagulation even after cytoreduction is achieved?

How would you consider anticoagulation vs antiplatelet therapy, or the addition of antiplatelet therapy for these patients?

2 Answers available

How would one approach concomitant diffuse large B cell lymphoma and fibrotic phase myelofibrosis?

1 Answer available

How do you choose between peginterferon and anagrelide for ET patients if hydroxyurea-intolerant?

1 Answer available

Is bone marrow biopsy indicated in patients with primary polycythemia but negative for JAK2 mutation including exon 12?

2 Answers available

Would you offer BM biopsy as the next step for progressive thrombocytosis when peripheral blood is negative for JAK2, CALR, and MPL mutations for MPN diagnosis?

1 Answer available

Does stopping anagrelide affect fibrosis in patients with ET who develop post-ET myelofibrosis?

1 Answer available

How do you manage MPN patients with acquired VWD in the perioperative setting?

Please specify your approach in elective and emergency surgical situations

1 Answer available

How do you manage and/or prevent ruxolitinib withdrawal syndrome?

1 Answer available

What aspirin dose do you favor for thrombotic prophylaxis in myeloproliferative neoplasms?

81 mg vs 162 mg

1 Answer available

Would you continue ruxolitinib in combination with HMA plus venetoclax in myelofibrosis at the time of transformation to AML?

1 Answer available

What workup and initial treatment should be considered for suspected autoimmune myelofibrosis?

1 Answer available

What is the benefit of cytoreduction with Hydroxyurea for patients with newly diagnosed chronic phase CML with a WBC count >100 prior to the initiation of a TKI?

1 Answer available

In someone with an asymptomatic JAK2 V617 mutated and BCR/ABL negative MPN with a steadily rising WBC, when do you decide to start cytoreductive therapy and which agent(s) do you recommend?

No evidence of palpable splenomegaly, normal hematocrit and platelet count

1 Answer available

Would you consider using HMA in management of polycythemia vera?

i.e. treatment-refractory PV, prior to progression to PMF or AML

1 Answer available

How should one manage a patient with leukocytosis and borderline detectable BCR-ABL without other clinical features of CML such as basophilia or splenomegaly?

e.g. IS < 0.002% by qPCR

1 Answer available

Do you adjust the dose of ruxolitinib in primary myelofibrosis based on hemoglobin?

1 Answer available

In young patients with essential thrombocythemia and early significant atherosclerotic disease but no thrombotic history, would you consider the addition of cytoreductive therapy?

Would the presence of JAK2 versus CALR versus MPL influence this decision? What if there are other risk factors for cardiovascular disease?

1 Answer available

In patients with high-risk polycythemia vera with a history of thrombosis, should aspirin be used in addition to indefinite anticoagulation and cytoreduction for prevention of recurrent thrombosis?

What if there are no cardiovascular risk factors? Are VKAs preferred or can DOACs be used?

1 Answer available

In the absence of symptoms would you still treat high risk myelofibrosis if transplant ineligible?

Is leukocytosis and thrombocytosis alone an indication for treatment?

1 Answer available

Would you treat iron deficiency in post PV myelofibrosis if anemia is the predominant concern?

1 Answer available

What is the role, if any, for next generation sequencing testing in patients with suspected MPN who test negative for commonly identified mutations such as JAK2, CALR, MPL, and BCR-ABL?

3 Answers available

How would you optimally manage a patient with a MDS/MPN overlap syndrome who has both transfusion-dependent anemia and marked thrombocytosis?

Would this change with someone who has a history of thrombosis (e.g. DVT/PE, MI, CVA)? Would this change with someone who is more fit vs more frail?

1 Answer available

How often do you monitor thiamine levels in a myelofibrosis patient taking fedratinib?

1 Answer available

Do you consider splenic response as adequate to judge efficacy of JAK2 inhibitors in myeloproliferative disorders?

1 Answer available

How would you manage acquired von Willebrand syndrome secondary to a myeloproliferative neoplasm in a patient who is already on anticoagulation?

Individuals with MPNs may be at higher risk for thrombosis and be placed on antiplatelet therapy or even anticoagulation because of prior thrombosis. ...

1 Answer available