Curriculum-Based Learning Activities
Recent clinical research on myeloproliferative disorders has offered hematology-oncology professionals the ability to recommend improved strategies for patient care—this in a medical setting that has traditionally been characterized by modestly effective chemotherapy-based treatment. For years, management options were limited for the group of malignancies classified as Philadelphia chromosome (Ph)–negative myeloproliferative neoplasms (MPN)s; this changed with the recognition that the JAK-STAT pathway (which is activated in normal hematopoiesis) was implicated in the pathogenesis of many MPNs. Such insight led, in part, to the development of new diagnostic criteria and to the emergence of a new class of therapies directed against JAK-STAT. These agents currently have applications in the setting of myelofibrosis (MF), and studies in polycythemia vera (PV) and essential thrombocythemia (ET) are underway.
Despite these advances, several clinical issues remain. Diagnosis remains challenging and relies on the clinician’s ability to recognize, assess, and distinguish between the various MPN symptoms. In addition, an accurate baseline prognosis, derived using modern risk assessment models, is central to good therapeutic planning. Finally, a keen awareness of the evidence that supports modern management approaches to MPNs can be difficult to maintain because of the rapid pace of clinical research, a phenomenon that often leads to delays in the clinical application of new science. This curriculum is designed to offer a glimpse of how community-based professionals are responding to these challenges, to offer expert advice on the practical implications of relevant research, and to illustrate how to choose the right therapy for the right patient with MF or other MPNs.