Overview of the Treatment of Myelofibrosis

Opinion
Video

A hematologist-oncologist gives an overview of the treatment of myelofibrosis by defining the disease and highlighting biological pathways, therapeutic options, and factors that drive treatment selection.

Case: A 62-Year-Old Man with Myelofibrosis

Clinical Presentation:

  • A 62-year-old man presented with symptoms of fatigue, night sweats, and increased bruising.
  • PMH: type 2 diabetes, hypercholesteremia, and hypertension
  • 1 year prior, patient had a “normal” physical and blood work.
    • PCP noticed lower Hg (11 to 9.5 g/dL) and Plt (350 to 195 cells/m3)
  • Patient was referred to Hem/Onc – first available appoint in 2 months.

Initial Clinical Workup and Diagnosis (Post-PCP Visit):

  • Exam: fatigue and night sweats worsening; bone pain.
  • Labs: RBC 3.40 x 1012/L; Hb 8.7 g/dL; Hct 36%; MCV 94fL; WBC 28.0 x 109/L; Plt 75 x 109/; LDH 330 IU/L
  • Spleen: 5 cm below LCM
  • Bone Marrow Fibrosis: Grade 2
  • Bone Marrow Blasts: 3%
  • Blood Smear: leukoerythroblastosis; 1% blasts by manual count/flow cytometry
  • Molecular Analysis: JAK V617F+
  • ECOG PS 2
  • Diagnosis: Primary MF

Current Treatments:

  • Patient was initiated on pacritinib.
Related Videos
Video 2 - "Setting Expectations + First-Line and Second-Line Treatment of Graft Versus Host Disease"
Video 1 - "Patient Case: Pathology of Graft Versus Host Disease"
Gary J. Schiller, MD, an expert on MDS
Gary J. Schiller, MD, an expert on MDS
Gary J. Schiller, MD, an expert on MDS
Gary J. Schiller, MD, an expert on MDS
Gary J. Schiller, MD, an expert on MDS
Gary J. Schiller, MD, an expert on MDS
Related Content