Andrew Kuykendall, MD, discusses the evolution of prognostication factors in primary and secondary myelofibrosis.
Andrew Kuykendall, MD, assistant member, the Department of Malignant Hematology, Moffitt Cancer Center, discusses the evolution of prognostication factors in primary and secondary myelofibrosis.
The heterogeneous nature of myelofibrosis highlights the importance of disease prognostication at all stages, Kuykendall says. Although early prognostic models used over a decade ago were based on clinical factors such as white blood cell count, hemoglobin levels, platelets, age, constitutional symptoms, and circulating blasts, now, prognostication increasingly includes genetics, which drive much of the heterogeneity of this disease, Kuykendall explains. Newer prognostication models build on the clinical factors of past models by also including specific mutations and the number of mutations a patient has, Kuykendall notes.
Additionally, unique prognostic models have been developed for patients who have secondary myelofibrosis, which is myelofibrosis that occurs after prior essential thrombocythemia or polycythemia vera, Kuykendall says. Moving toward more individualized care has allowed for the evolution of increasingly effective treatment strategies, as well as a better understanding of each patient’s risk, Kuykendall concludes.