Dr. Ruben Mesa on New NCCN Guidelines for MPNs

Ruben Mesa, MD chair, hematology Mayo Clinic, MPN, discusses the new National Comprehensive Cancer Network (NCCN) guidelines for myeloproliferative neoplasms (MPN).

The NCCN Guidelines for MPN specifically outline diagnosis, treatment, and supportive care strategies for myelofibrosis.

The guidelines stress the importance of an accurate diagnosis and an establishment of prognosis using the International Prognostic Scoring System (IPSS) or the Dynamic International Prognostic Scoring System (DIPSS) throughout the course of the disease along with symptom assessment, says Mesa.

Treatment is then stratified based on risk; with low-risk stratifying patients that are symptomatic and asymptomatic, intermediate 1, and intermediate 2 and high risk. The currently approved therapy of ruxolitinib is utilized at each risk level depending on whether a patient is symptomatic in the low and intermediate 1 phases, and in all patients that are intermediate 2 or high risk.

The guidelines also specify when allogeneic stem cell transplant should be used based on risk level. In low and intermediate 1 risk patients it is an option for some who have high-risk molecular disease, while in intermediate 2, and high risk patients it should be a strong consideration, says Mesa.

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