Dr Gerds on Disease Progression Patterns in Low-Risk Myelofibrosis

Aaron Gerds, MD, assistant professor, medicine, Hematology, and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, discusses findings from the prospective, observational MOST trial (NCT02953704), which collected disease progression data for patients with low- or intermediate-1–risk myelofibrosis.

Gerds begins by noting that the study was split into two cohorts. Cohort A (n = 205) consisted of patients with low-risk or intermediate-1–risk disease, where patients were considered to have intermediate-1–risk myelofibrosis based on age only. Cohort B (n = 27) consisted of patients with intermediate-1–risk disease with other Dynamic International Prognostic Scoring System (DIPSS) risk factors beyond age.

Findings presented by Gerds and collogues at the 2024 EHA Congress showed that at a median follow-up of more than 4 years, 58.5% of patients in cohort A experienced disease progression. Of the 120 patients who experienced disease progression, 64 (53.3%) met 1 criterion, 27 (22.5%) met 2 criteria, and 29 (24.2%) met at least 3 disease progression criteria. The most common progression criteria met in cohort A included a hemoglobin level of less than 10 g/dL (47.5%) and a platelet count of less than 100 x 109/L (31.7%).

For Cohort B, 25 patients (92.6%) met 1 progression criterion, 1 patient (3.7%) met 2 progression criteria, and 1 patient (3.7%) met 3 progression criteria. In this cohort, the most frequent progression criteria met were a hemoglobin level of less than 10 g/dL (51.9%) and a white blood cell count of greater than 25 x 109/L (29.6%).

The rate of patients in cohort A who experienced disease progression during the study was notably high, Gerds explains. When considering progression-free survival for patients with low-risk myelofibrosis, Gerds says clinicians generally think of this time in terms of years rather than months; however, findings from this study showed that a considerable number of patients with low-risk disease experienced progression during the study time frame, he concludes.