The MPN Hub was pleased to speak to Aaron Gerds, Cleveland Clinic Taussig Cancer Institute, Cleveland, US. We asked, How might luspatercept benefit patients with myelofibrosis (MF)? 

Aaron Gerds opens by discussing the prevalence and issue of anemia in patients with MF, noting that almost all patients will become anemic at some point in the course of their disease. Gerds discusses luspatercept as a treatment option in this indication, sharing the latest clinical trial data and emphasizing the benefit of a reduction in transfusion dependency for patients treated with luspatercept. The interview closes with a look to ongoing clinical trials, including the INDEPENDENCE study and the implications of these data on future management strategies for anemic myelofibrosis.

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During the European Hematology Association (EHA) 2024 Hybrid Congress, the MPN Hub was pleased to speak with Haifa Kathrin Al-Ali, University Hospital Halle, Halle, DE. We asked, What more can be done to improve treatment for patients with polycythemia vera?

Al-Ali provides an overview of how to improve treatment and outcomes for patients with polycythemia vera, opening with a discussion of the latest advancements in the field and key areas for improvement. Al-Ali shares insights on symptoms management, risk stratification, and the potential applications for machine learning and artificial intelligence in MPN. This interview concludes with a discussion of the goals for treatment and how these may vary between patients and physicians, highlighting the importance of the patient voice in the treatment of MPN.

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The MPN Hub was pleased to speak to Laura Michaelis, Medical College of Wisconsin, Milwaukee, US and Anand Patel, University of Chicago, Chicago, US. We asked, When to refer patients with MPN to clinical trials: Part II - Patients with myelofibrosis (MF).

Patel opens by highlighting the need for more long-term effective MF treatments and presents long-term data on the cessation of existing therapies such as ruxolitinib. Michaelis and Patel then discuss factors that influence the decision to refer to a clinical trial in patients with newly diagnosed MF; outlining anemia and other symptoms as indicators for referral. They also discuss add-on clinical trials as options for patients who do not achieving optimal response with their current standard of care treatment.

The podcast concludes with a discussion on clinical trial referral versus transplantation in patients not achieving an optimal treatment response with standard of care. Finally, the importance of communicating effectively with the patient and considering their comorbidities is highlighted.

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The MPN Hub was pleased to speak to Laura Michaelis, Medical College of Wisconsin, Milwaukee, US and Anand Patel, University of Chicago, Chicago, US. We asked, When to refer patients with MPN to clinical trials: Part I — Patients with essential thrombocytopenia/polycythemia vera.

In this podcast, Michaelis and Patel discuss the factors which determine whether standard of care treatment or referral to a clinical trial is the most appropriate course of action. Patel begins by outlining drugs currently under clinical trial for essential thrombocytopenia and polycythemia vera.  Michaelis and Patel then consider the importance of aligning trial endpoints with the individualized treatment goals of patients. They conclude by discussing how the progression of a patient to second-line therapy, as well as cytogenetic abnormalities that indicate more aggressive disease progression, may underly the decision to consider clinical trials that align with a patient’s goals.

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During the 63rd ASH Annual Meeting and Exposition, the MPN Hub was pleased to speak to Laura Michaelis (Medical College of Wisconsin, Milwaukee, US) and Claire Harrison (Guy's and St Thomas' NHS Foundation Trust, London, UK). We asked, Patient follow-up in myeloproliferative neoplasms: Best practices and myths. 

In this podcast, Michaelis and Harrison discuss the best practices in MPN, in particular in regards to diagnosis. They also discuss the new data that was presented at ASH 2021, such as the MOMENTUM (NCT04173494) study and momelotinib.  

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During the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, the MPN Hub spoke to Marina Kremyanskaya, Icahn School of Medicine at Mount Sinai, New York, US. We asked, Is the hepcidin-mimetic PTG‑300 a promising treatment for therapeutic phlebotomy-dependent polycythemia vera (PV)?

Currently, patients with PV require frequent phlebotomy. Kremyanskaya discusses promising results from a phase II clinical trial evaluating the safety and efficacy of PTG-300, a novel hepcidin-mimetic, in patients with PV who received three or more phlebotomies up to 6 months before treatment. Kremyanskaya highlights that the need for phlebotomy was eliminated in patients treated with PTG-300. In addition, PTG-300 was well tolerated.

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During the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, the MPN Hub spoke to Jyoti Nangalia, University of Cambridge, Cambridge, UK. We asked, Should we consider early testing and treatment for driver mutations acquired in childhood?

In this podcast, Jyoti Nangalia reports results from a study using next-generation sequencing to trace acquired MPN mutations in hematopoietic stem cells taken from patients with varying stages of disease presentation. Nangalia discusses unexpected results, such as the acquisition of key driver mutations (JAK2 and DNMT3A) very early in life. She also discusses results observing a variation in the growth rate of cancer cell clones between patients, as well as the correlation of growth rate with disease presentation. Nangalia concludes with possible future applications of these methods in the early detection and prevention of MPN. 

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During the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, the MPN Hub spoke to the Steering Committee Chair, Jean-Jacques Kiladjian, Université de Paris, Paris, FR. We asked, When can we safely discontinue interferon alpha therapy in patients with myeloproliferative neoplasms?

Results from several studies have shown that interferon alpha is able to induce high rates of complete hematological remission in patients with polycythemia vera, but what are the outcomes in patients who had received interferon alpha and then discontinued treatment?

Kiladjian reports the results of a study comparing the clinical outcome of patients with myeloproliferative neoplasms who discontinued therapy after at least three months of interferon alpha treatment to patients who continued interferon alpha treatment despite achieving a complete hematological remission.

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During the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, the MPN Hub spoke to Ghaith Abu-Zeinah, Weill Cornell Medicine, New York, US. We asked, Does interferon alpha prolong survival and prevent progression in patients with polycythemia vera (PV)?

PV is a disease associated with shorter survival due to short-term complications, such as thrombosis, and long-term complications of progression to myelofibrosis and transformation to acute leukemia, which are associated with poor prognosis. The current treatment guidelines for PV recommend phlebotomy only for low-risk patients and, for a long time, these guidelines favored hydroxyurea over interferon alfa for the initial treatment of high-risk patients.

In this podcast, Abu-Zeinah shares the key findings of a retrospective study comparing myelofibrosis-free survival and overall survival of 470 patients with PV treated with recombinant interferon alfa, hydroxyurea, or phlebotomy only.

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During the First Annual Texas Virtual MPN Workshop, the MPN Hub spoke to our Steering Committee members Laura Michaelis, Medical College of Wisconsin, Milwaukee, US, and Tiziano Barbui, Papa Giovanni XXIII Hospital, Bergamo, IT. We asked, What do we know about the outcome of concomitant MPN and COVID-19?

In this podcast, Tiziano Barbui starts by giving some background to the COVID-19 pandemic in Europe. Prof. Barbui has focused on how to help his patients with myeloproliferative neoplasms (MPN) during the outbreak. As a member of the European LeukemiaNet Working party on MPN, Prof. Barbui launched a study in 38 European centers, collecting 180 patients with both MPN and COVID-19. Laura Michaelis asks, are patients with MPN more susceptible to COVID-19 infection? Prof. Barbui discusses this question with reference the prevalence of people infected with COVID-19, who are asymptomatic but show serum-positivity.

Then, Prof. Michaelis asks what the fatality rate was in patients with MPN who also contracted COVID-19. Tiziano Barbui speaks about the results that he found in his hospital and in the study he commissioned. Laura Michaelis highlights that the stage of the epidemic also impacts on case fatality. They go on to comment on the type of comorbidities present in patients with MPN and how this effects their risk of severe disease with COVID-19. This leads to a discussion of the important variables identified during analysis of the data from Prof. Barbui's study. Prof. Michaelis in particular asks about how ruxolitinib modifies the risk for patients with MPN. Tiziano Barbui answers this, paying particular attention to the inflammatory environment in patients with COVID-19.

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