Dr Prithviraj Bose Discusses Identifying Progression in Myelofibrosis

There are formal criteria to identify progression in myelofibrosis, but patients can progress in many different ways, said Prithviraj Bose, MD, of MD Anderson Cancer Center.

How do you identify progression in myelofibrosis?

Essentially there are the IWG-MRT [International Working Group-Myeloproliferative Neoplasms Research and Treatment] 2013 criteria that are kind of formal criteria for progression, but those are really to do with the spleen progression and to do with leukemic transformation, and pretty much that’s it.

However, in practice, a patient can progress in many ways. You can have the spleen grow; you can have symptoms worsen; you can have blood counts worsen, by which I mean more anemia, more thrombocytopenia; you can have the white blood cell count go up; and of course you can have the blasts go up and end up in accelerated or blastic phase, which is really the same as leukemic transformation.

So, it can be any of these things or more than one in combination, because you know patients don’t always progress in just one dimension.