How do you incorporate prognostic mutations into your management of primary myelofibrosis?

Mutational testing is critical to help diagnose, prognosticate, and make treatment decisions in primary myelofibrosis. I obtain JAK2/CALR/MPL on all patients and also obtain an extended NGS panel to determine if there are any high molecular risk markers, such as SRSF2, EZH2, IDH1/2, and ASXL1. Mutations first help to make the diagnosis. I then utilize mutations to determine what risk group my patient falls into. I utilize DIPSS+ before having genetic information and MIPSS70v2 once I have molecul...