Disclosures for Ayalew Tefferi
|
|
- Constance Flynn
- 6 years ago
- Views:
Transcription
1 Disclosures for Ayalew Tefferi Principal investigator role Employee Consultant Major Stockholder Speakers Bureau Scientific Advisory Board Janssen, Geron, Celgene, Sanofi-Aventis, Gilead Sciences, Incyte None None None None None Presentation includes discussion of the following off-label use of a drug or medical device: Hydroxyurea, Interferon-alpha, Busulfan, Thalidomide, Lenalidomide, Pomalidomide, Ruxolitinib, Androgen preparations, Erythropoiesis stimulating agents
2 Emerging Issues of Myeloproliferative Neoplasms Research 2016 Ayalew Tefferi, MD Mayo Clinic, Rochester, MN
3 Chronic Myeloid Malignancies Myelodysplastic Syndromes Myelodysplastic/ Myeloproliferative overlap Myeloproliferative Neoplasms Myeloid/Lymphoid neoplasm with eosinophilia and PDGFR/FGFR1 mutation MORPHOLOGY Absence of cytosis Dyserythropoiesis Dysgranulopoiesis Monocytosis Granulocytosis Thrombocytosis Erythrocytosis Eosinophilia Mastocytosis Presence of PDGFRA/B or FGFR1 mutation MUTATIONS MDS -TET2 20% RARS -SF3B % Tefferi and Pardanani. JAMA Oncology 2015 (modified) CMML -TET % -SRSF % -ASXL1 40% Dyserythropoiesis RARS-T Dysgranulopoiesis -SF3B % -JAK2V617F 50% acml -SETBP1 30% MDS/MPN-U Monocytosis CML -BCR-ABL1 100% PV -JAK2 99% ET -JAK2/CALR/MPL 85% PMF -JAK2/CALR/MPL 90% CNL -CSF3R % -SETBP1 30% SM -KITD816V % CEL MPN-U PDGFRA rearranged -FIP1L1-PDGFRA 100% PDGFRB rearrange -PDGFRB mutation 100% FGFR1 rearranged -FGFR1 mutation 100%
4 Objectives 1. New developments in laboratory investigation 2. WHO revisions in diagnostic criteria for PV, ET and PMF 3. Mutations and prognosis 4. Revised risk stratification in essential thrombocythemia 5. New developments in treatment
5 The calreticulin protein CALR located on 19p exons Mendlovic F. Nature Education 2010 Exon 9 indel mutations-1bp reading frameshift Mutational frequencies 20-30% in ET or PMF Specific to JAK2-unmutated ET and PMF Mutually exclusive of JAK2 and MPL mutations Klampfl et al. Nangalia et al. NEJM 2013
6 Chachoua et al. Blood First Edition Araki et al. Blood First edition Retroviral mouse transplant model for mutant CALR Marty et al. Blood First Edition CALR mutants specifically activate TpoR and the extracellular domain, but not the Tpo-binding site is essential in this regard Oncogenic signaling requires JAK2 Tpo-independent megakaryocyte proliferation in CALR-mutated patients requires TpoR and JAK2
7 Diagnosis
8 2016 Proposed Revised WHO Diagnostic Criteria (Barbui et al. Blood Cancer Journal (2015) 5, e337; doi: /bcj Published online 14 August 2015) Polycythemia Vera Essential Thrombocythemia Primary Myelofibrosis Prefibrotic Primary Myelofibrosis Major 1 Hemoglobin (Hgb) 1 Platelet count 450 x 10 9 /L 1 Megakaryocyte proliferation and atypia*** Megakaryocyte proliferation and atypia*** criteria >16.5 g/dl (men) >16 g/dl (women) or Hematocrit >49% (men) >48% (women) and grade 2 reticulin/collagen fibrosis ***megakaryocytes with aberrant nuclear/cytoplasmic ratio and hyperchromatic and irregularly folded nuclei and dense clustering and grade 1 reticulin/collagen fibrosis, Increased cellularity, granulocytic Proliferation and decreased erythropoiesis 2 BM trilineage myeloproliferation 2 BM megakaryocyte proliferation 2 Not meeting WHO criteria for Not meeting WHO criteria for with pleomorphic megakaryocytes with large and mature morphology other myeloid neoplasm other myeloid neoplasm 3 Not meeting WHO criteria for 3 Presence of JAK2, CALR or MPL mutation Presence of JAK2, CALR or MPL mutation 3 Presence of JAK2 mutation other myeloid neoplasms or or 4 Presence of JAK2, CALR or MPL mutation presence of another clonal marker or absence of evidence for reactive presence of another clonal marker or absence of evidence for reactive bone marrow fibrosis bone marrow fibrosis Minor 1. Subnormal serum Epo level 1. Presence of a clonal marker 1 1. Anemia 1. Anemia criteria or absence of evidence for reactive 2. Leukocytosis 2. Leukocytosis thrombocytosis 3. Palpable splenomegaly 3. Palpable splenomegaly 4. Increased LDH 4. Increased LDH 5. Leukoerythroblastosis (diagnosis requires meeting all three major criteria or the first two major criteria and one minor criterion diagnosis requires meeting all 4 major criteria or first three major criteria and one minor criterion diagnosis requires meeting all 3 major criteria and at least one minor criterion diagnosis requires meeting all 3 major criteria and at least one minor criterion
9 Practical algorithm for diagnosis of myeloproliferative neoplasm Tefferi and Pardanani; JAMA Oncology 2015 Polycythemia vera suspected Essential thrombocythemia suspected Primary myelofibrosis suspected lood mutation screening JAK2V617F+ If negative Blood mutation screening JAK2V617F+ If negative Bone marrow biopsy with mutation screening and cytogenetics JAK2 exon 12+ If negative Diagnosis likely Bone marrow examination advised to confirm diagnosis CALR+ If negative Bone marrow examination required to confirm diagnosis and distinguish ET from prefibrotic PMF Subnormal serum erythropoietin level MPL+ If negative Diagnosis unlikely If JAK2 unmutated and serum erythropoietin level normal or increased Triple-negative Diagnosis considered If bone marrow morphology is consistent with PMF and 1. JAK2, CALR or MPL mutated or 2. trisomy 9 or del(13q) present or 3. Other myeloid malignancies are excluded
10 Survival and Prognosis
11 Tefferi et al. Blood 2014 Comparison of survival in 826 Mayo Clinic patients with essential thrombocythemia vs polycythemia vera vs primary myelofibrosis.
12 Tefferi et al. Blood 2015 Comparison of survival in 389 young patients with essential thrombocythemia vs polycythemia vera vs primary myelofibrosis.
13 Elala et al. Submitted Overall survival in 495 patients with essential thrombocythemia stratified by driver mutational status
14 Elala et al. Submitted Myelofibrosis-free survival in 495 patients with essential thrombocythemia stratified by driver mutational status
15 Elala et al. Submitted Thrombosis-free survival in 495 patients with essential thrombocythemia stratified by driver mutational status
16 Targeted deep sequencing in 183 patients with essential thrombocythemia RED: Sequence variants previously associated with a hematologic malignancy and shown to be somatic PINK: Sequence variants previously associated with a hematologic malignancy and with 1% minor allele frequency in current databases for single nucleotide polymorphisms BLUE: Sequence variants with 1% minor allele frequency in current databases for single nucleotide polymorphisms 1. Prevalence of mutations/variants other than JAK2/CALR/MPL = 53% 2. Driver mutational status did not affect prevalence 3. Most frequent were ASXL1 andtet %, 8% and 4% harbored 1, 2 or 3 such mutations 5. 6 genes were identified as being affected by adverse mutations/variants Tefferi et al. Submitted
17 Targeted deep sequencing in 133 patients with polycythemia vera RED: Sequence variants previously associated with a hematologic malignancy and shown to be somatic PINK: Sequence variants previously associated with a hematologic malignancy and with 1% minor allele frequency in current databases for single nucleotide polymorphisms BLUE: Sequence variants with 1% minor allele frequency in current databases for single nucleotide polymorphisms 1. Prevalence of mutations/variants other than JAK2/CALR/MPL = 53% 2. Most frequent were ASXL1 andtet %, 20% and 3% harbored 1, 2 or 3 such mutations 4. 3 genes were identified as being affected by adverse mutations/variants Tefferi et al. Submitted
18 PV ET Tefferi et al. Submitted
19 Myelofibrosis-free survival in 132 Italian patients with polycythemia vera seen at the University of Florence, Italy, and stratified by the presence or absence of adverse sequence variants P<.0001 w/o adverse variants N=91 Median not reached with adverse variants N=41 Median 11.2 ( ) yrs HR 9.5, 95% CI Tefferi et al. Submitted
20 Leukemia-free survival Leukemia-free survival in 183 patients with essential thrombocythemia stratified by the presence or absence of adverse sequence variants/mutation 1 No adverse variants N=156 Leukemic transformations = 2 (1.3%) With adverse variants N=27 Leukemic transformations = 4 (14.8%).2 0 P< Tefferi et al. Submitted Years
21 Survival Survival data on 438 patients with primary myelofibrosis stratified by mutational status: Mayo-Florence patients JAK2 mutated N=265 Median 5.7 years CALR mutated N=93 Median 16 years.2 Triple negative N=53 Median 2.3 years MPL mutated N=27 Median 9.9 years P< Tefferi et al. Blood 2014 Years
22 Survival Survival data on 440 Mayo Clinic patients with JAK2 or CALR mutated primary myelofibrosis 1 JAK2V617F vs type 1/type 1-like, p<0.0001; HR 2.7, 95% CI JAK2V617F vs type 2/type 2-like, p=0.84; HR 1.1, 95% CI Type 2/type 2-like vs type 1/type 1-like, p=0.003; HR 2.5, 95% CI Type-1/type 1-like CALR mutated N=110 Median 13.7 years.4.2 Type-2/type 2-like CALR mutated N=21 Median years 0 JAK2-mutated N=309 Median 4 years Tefferi et al. Blood 2014 Years
23 Survival data on 325 Florence (Italy) patients with JAK2 or CALR mutated primary myelofibrosis Guglielmelli et al. Blood Cancer Journal (2015) 5, e360; doi: /bcj
24 Survival Survival in 722 Mayo Clinic patients with primary myelofibrosis stratified by driver mutational status CALR type 1/type 1-like N=115 Median 10.3 years P< Triple-negative N=65 Median 3.1 years.2 CALR type 2/type 2-like N=24 Median 3.5 years MPL-mutated N=41 Median 6 years 0 JAK2-mutated N=477 Median 3.8 years Tefferi et al. ASH 2015 Years
25 Targeted deep sequencing in 182 patients with primary myelofibrosis A) B) RED: Sequence variants previously associated with a hematologic malignancy and shown to be somatic PINK: Sequence variants previously associated with a hematologic malignancy and with 1% minor allele frequency in current databases for single nucleotide polymorphisms BLUE: Sequence variants with 1% minor allele frequency in current databases for single nucleotide polymorphisms 1. Prevalence of mutations/variants other than JAK2/CALR/MPL = 81% 2. Prevalence was 83% in JAK2, 73% CALR, 91% MPL and 82% triple-negative (p=0.43) 3. Most frequent were ASXL1 36%, TET2 18%, SRSF2 18%, U2AF1 16% 4. 35%, 26%, 10% and 9% harbored 1, 2, 3 or 4 such mutations 5. 7 genes were identified as being affected by adverse mutations/variants Tefferi et al. Submitted
26 Survival Survival in 182 patients with primary myelofibrosis stratified by the presence or absence of adverse or non-adverse sequence variants/mutation 1 Adverse sequence variants/mutations: 7 genes were identified as being involved with adverse mutations/variants.8.6 No sequence variants/mutations N=35 Median survival not reached.4 Non-adverse variants/mutations N=45 Median survival = 6.8 years HR 2.5 (95% CI ).2 0 P< Adverse variants/mutations N=102 Median survival = 3.6 years HR 5.1 (95% CI ) Tefferi et al. Submitted Years
27 Survival Survival in 182 patients with primary myelofibrosis stratified by the number of adverse sequence variants/mutation Adverse sequence variants/mutations: 7 genes were identified as being involved with adverse mutations/variants 1.8 P< No adverse variants/mutations N=80 Median survival = 8.5 years Three or more adverse variants/mutations N=9 Median survival = 0.65 years HR 18.8 (95% CI ) One or two adverse variants/mutations N=93 Median survival = 4 years HR 2.7 (95% CI ) Tefferi et al. Submitted Years
28 Survival Overall survival in 369 patients with primary myelofibrosis stratified by genetics-based prognostic scoring system (GPSS) 1 GPSS risk categories High Score 5 Intermediate-2 Score 3 or 4 Intermediate-1 Score 1 or 2 Low Score 0 GPSS variables.8.6 Low N=31 Median not reached Karyotype Very high risk = 3 High risk = 1 Mutations Triple-negative = 2 JAK2 = 2 MPL = 2 Type 2/type 2-like CALR = 2 ASXL1 = 1 SRSF2 = 1 Age >60 = High N=115 Median 2.2 yrs Intermediate-2 N=133 Median 5 yrs Intermediate-1 N=90 Median 9 yrs Karyotype Very high risk Monosomal Inv(3) i(17q) -7/7q- 11q abns 12p- High risk Complex not MK Two abns 5q- +8 Other trisomies Other sole abns Years Tefferi et al. ASH 2014
29 New Risk Stratification in Essential Thrombocythemia
30
31 Practice-relevant revision of IPSET-thrombosis based on 1019 patients with WHO-defined essential thrombocythemia Barbui et al. Blood Cancer Journal (2015) 5, e369; doi: /bcj
32 Contemporary treatment algorithm in essential thrombocythemia (ET) and polycythemia vera (PV) (all patients with polycythemia vera require phlebotomy to a hematocrit target of <45%) Very low-risk disease No history of thrombosis Age 60 years JAK2-unmutated Low-risk disease No history of thrombosis Age 60 years JAK2 mutated Intermediate-risk disease Age >60 years No history of thrombosis JAK2 unmutated High-risk disease History of thrombosis or Age >60 years with JAK2 mutation Without CV risk factors With CV risk factors Arterial thrombosis history at any age Venous thrombosis history at any age Observation alone Once-daily aspirin Without CV risk factors Once-daily aspirin With CV risk factors Hydroxyurea + once-daily aspirin Hydroxyurea + once-daily aspirin Hydroxyurea + systemic anticoagulation Avoid aspirin in the presence of extreme thrombocytosis and acquired von Willebrand syndrome With CV risk factors age >60 years or JAK2-mutated or CV risk factors JAK2-mutated or CV risk factors Consider twice-daily aspirin Cytoreductive therapy might not be essential Consider twice-daily aspirin Consider once-daily aspirin Modified from Tefferi and Barbui AJH 2015
33 Treatment Myelofibrosis
34 Myelofibrosis Rx Algorithm Type 1 Type 1 Type 1 Type 1 Tefferi A. AJH 2014
35 Leukemia 2014
36
37 Survival Figure 1a 1.8 Ruxolitinib-treated, n=51.6 P= No ruxolitinib, n= Months Tefferi et al. NEJM 2011:365;15
38 Survival Figure 1 Survival in 542 Mayo Clinic patients with high or intermediate-2 risk myelofibrosis stratified by treatment with momelotinib 1.8 Momelotinib treated N=100 Median 3.2 years P= Momelotinib-naive N=442 Median 3.8 years 0 Tefferi et al. ASH Years
39 Pardanani et al. Leukemia (2015) 29,
40 Non-canonical mechanism of action Canonical mechanism of telomerase activity Telomeres Telomerase Imetelstat Regulation of transcription Mitochondrial RNA processing and ROS production
41 Status of All 33 Patients Treated with Imetelstat 9.4 mg/kg IV every 1 to 3 weeks Median age 67 years; primary PMF 55%; DIPSS-plus high 52% and int-2 48%; prior JAKi therapy 49%; Abnormal karyotype 55%; Tx-dependent 39%; Median palpable spleen 15 cm CR/PR = 7 (21.2%) patients Median time to response onset=3.5 months ( ) Median response duration= 18/10 months in CR/PR All 4 CR patients achieved reversal of fibrosis 3 CR patients had molecular responses CR/PR 27% in JAK2-mutated vs 0% in unmutated CR/PR 32% in ASXL1-unmutated vs 0% in mutated CR 38% in SF3B1/U2AF1 mutated vs 4% otherwise CR/PR/CI = 12 (36%) patients Spleen response =35% Tx-independency = 31% LES response = 82% Efficacy Leukocytosis response = 80% Thrombocytosis response = 100% Toxicity ( treatment-related ) Grade 3 non-hematologic toxicity infrequent Grade 4 myelosuppression: 18.2% thrombocytopenia 12.1% neutropenia 30% grade-3 anemia Grade 1 or 2 LFT frequent Bili 12.1% ALP 21.2% Transaminases 27.3% 41 Tefferi et al. NEJM 2015
42 Pre and post imetelstat mutation screening in 2 CR patients Patient #1 U2AF1Q157P T>G Patient #2 Baseline Granulocyte Buccal 3 month Granulocyte 4 month Granulocyte 6 month Granulocyte 10 month Granulocyte 13 month Granulocyte 16 month Granulocyte Tefferi et al. NEJM 2015
Disclosures for Ayalew Tefferi
Disclosures for Ayalew Tefferi Principal investigator role Employee Consultant Major Stockholder Speakers Bureau Scientific Advisory Board Janssen, Geron, Celgene, Sanofi-Aventis, Gilead Sciences, Incyte
More informationDisclosures for Ayalew Tefferi
Disclosures for Ayalew Tefferi Principal investigator role Employee Consultant Major Stockholder Speakers Bureau Scientific Advisory Board Janssen, Geron, Celgene, Sanofi-Aventis, Gilead Sciences, Incyte
More informationDisclosures for Angela Fleischman
Disclosures for Angela Fleischman Principal investigator role Employee Consultant Major Stockholder Speakers Bureau Scientific Advisory Board Sierra, Incyte None None None Incyte None Presentation includes
More informationWelcome to Master Class for Oncologists. Session 3: 9:15 AM - 10:00 AM
Welcome to Master Class for Oncologists Session 3: 9:15 AM - 10:00 AM Miami, FL December 18, 2009 Myeloproliferative Neoplasms: Bringing Order to Complexity and Achieving Optimal Outcomes Speaker: Andrew
More informationWHO Update to Myeloproliferative Neoplasms
WHO Update to Myeloproliferative Neoplasms Archana M Agarwal, MD, Associate Professor of Pathology University of Utah Department of Pathology/ARUP Laboratories Myeloproliferative Neoplasms The categories
More informationOpportunities for Optimal Testing in the Myeloproliferative Neoplasms. Curtis A. Hanson, MD
Opportunities for Optimal Testing in the Myeloproliferative Neoplasms Curtis A. Hanson, MD 2013 MFMER slide-1 DISCLOSURES: Relevant Financial Relationship(s) None Off Label Usage None 2013 MFMER slide-2
More informationDisclosure BCR/ABL1-Negative Classical Myeloproliferative Neoplasms
Disclosure BCR/ABL1-Negative Classical Myeloproliferative Neoplasms Sonam Prakash declares affiliation with Incyte Corporation: Advisor for Hematopathology Publications Steering Committee Sonam Prakash,
More informationCME Information: Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification, and management
AJH CME Information: Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification, and management Author: Ayalew Tefferi If you wish to receive credit for this activity,
More informationPresenter Disclosure Information
Welcome to Master Class for Oncologists Session 3: 2: PM 3:3 PM Pasadena, CA May 1, 21 Myeloproliferative Neoplasms 21 Speaker: Ayalew Tefferi Mayo Clinic, Rochester, MN Presenter Disclosure Information
More informationJAK inhibitors in Phmyeloproliferative
Disclosures for A Pardanani Research Support/P.I. Employee Consultant Major Stockholder Speakers Bureau Scientific Advisory Board TargeGen, Cytopia/YM BioSciences, PharmaMar None None None None None Presentation
More informationMPN What's new in the morphological classification, grading of fibrosis and the impact of novel drugs
MPN What's new in the morphological classification, grading of fibrosis and the impact of novel drugs Hans Michael Kvasnicka University of Frankfurt, Germany hans-michael.kvasnicka@kgu.de Disclosure of
More informationWhat are myeloproliferative neoplasms??
Welcome to Master Class for Oncologists Session 3: 2:45 PM - 3:30 PM New York, NY October 24, 2008 Myeloproliferative Neoplasms Speaker: Ayalew Tefferi, MD Professor of Medicine, Mayo Clinic, Rochester,
More informationMayo Clinic Treatment Strategy in Essential Thrombocythemia, Polycythemia Vera and Myelofibrosis 2013 Update
Mayo Clinic Treatment Strategy in Essential Thrombocythemia, Polycythemia Vera and Myelofibrosis 2013 Update Ayalew Tefferi Mayo Clinic, Rochester, MN 0 20 40 60 80 100 Percent Survival in 337 Mayo Clinic
More informationManaging ET in Tiziano Barbui MD
Managing ET in 2019 Tiziano Barbui MD (tbarbui@asst-pg23.it) Hematology and Foundation for Clinical Research, Hospital Papa Giovanni XXIII Bergamo, Italy Managing ET in 2019 Establish diagnosis Risk Stratification
More informationLeukemia and subsequent solid tumors among patients with myeloproliferative neoplasms
Leukemia and subsequent solid tumors among patients with myeloproliferative neoplasms Tiziano Barbui (tbarbui@asst-pg23.it Hematology and Research Foundation,Ospedale Papa Giovanni XXIII, Bergamo Italy
More informationMyeloproliferative Neoplasms
Myeloproliferative Neoplasms (MPN and MDS/MPN) Attilio Orazi, MD, FRCPath Weill Cornell Medical College/ NY Presbyterian Hospital, New York, NY USA EAHP EDUCATIONAL SESSION: Updated WHO classification
More informationUpdate on Myelodysplastic Syndromes and Myeloproliferative Neoplasms. Kaaren Reichard Mayo Clinic Rochester
Update on Myelodysplastic Syndromes and Myeloproliferative Neoplasms Kaaren Reichard Mayo Clinic Rochester Reichard.kaaren@mayo.edu Nothing to disclose Conflict of Interest Learning Objectives Present
More informationMYELOPROLIFERATIVE NEOPLASMS
9 : 2 MYELOPROLIFERATIVE NEOPLASMS Introduction William Dameshek in 1951 introduced the term Myeloproliferative disorders (MPD). This included polycythemia vera (PV), essential thrombocythemia (ET), primary
More informationDisclosures. I do not have anything to disclose. Shared Features of MPNs. Overview. Diagnosis and Molecular Monitoring in the
Myeloproliferative Neoplasms: Diagnosis and Molecular Monitoring in the Target Therapy Era C. Cameron Yin, M.D., Ph.D. Department of Hematopathology UT MD Anderson Cancer Center Disclosures I do not have
More informationWHO 2016/17 update on Myeloproliferative Neoplasms. Anna Ruskova Auckland City Hospital New Zealand
WHO 2016/17 update on Myeloproliferative Neoplasms Anna Ruskova Auckland City Hospital New Zealand BLOOD, 19 MAY 2016 x VOLUME 127, NUMBER 20 2 2016/17 Classification of Myeloproliferative Neoplasms Chronic
More informationDisclosures for Ayalew Tefferi
Disclosures for Ayalew Tefferi Principal investigator role Employee Consultant Major Stockholder Speakers Bureau Scientific Advisory Board Janssen, Geron, Celgene, Sanofi-Aventis, Gilead Sciences, Incyte
More informationASH 2013 Analyst & Investor Event
ASH 2013 Analyst & Investor Event December 9, 2013 John A. Scarlett, MD President & CEO Forward-Looking Statements Except for the historical information contained herein, this presentation contains forward-looking
More informationMPNs: JAK2 inhibitors & beyond. Mohamed Abdelmooti (MD) NCI, Cairo University, Egypt
MPNs: JAK2 inhibitors & beyond Mohamed Abdelmooti (MD) NCI, Cairo University, Egypt Myeloproliferative Neoplasms (MPNs) AGENDA: 1. Molecular biology 2. New WHO diagnostic criteria. 3. Risk stratification
More informationThe prognostic relevance of serum lactate dehydrogenase and mild bone marrow reticulin fibrosis in essential thrombocythemia
Received: 3 February 2017 Revised: 13 February 2017 Accepted: 14 February 2017 DOI: 10.1002/ajh.24689 RESEARCH ARTICLE The prognostic relevance of serum lactate dehydrogenase and mild bone marrow reticulin
More informationMyeloproliferative Neoplasms: Diagnosis and Molecular Monitoring in the Era of Target Therapy
Myeloproliferative Neoplasms: Diagnosis and Molecular Monitoring in the Era of Target Therapy C. Cameron Yin, M.D., Ph.D. Department of Hematopathology UT MD Anderson Cancer Center Disclosures I do not
More information[COMPREHENSIVE GENETIC ASSAY PANEL ON
2014 SN GENELAB AND RESEARCH CENTER DR. SALIL VANIAWALA, PH.D [COMPREHENSIVE GENETIC ASSAY PANEL ON MYELOPROLIFERATIVE NEOPLASMS] SN Genelab presents one of the most comprehensive genetic assay panel for
More informationIntro alla patologia. Giovanni Barosi. Fondazione IRCCS Policlinico San Matteo Pavia
Settima Giornata Fiorentina dedicata ai pazienti con malattie mieloproliferative croniche Sabato 13 Maggio 2017 CRIMM Centro di Ricerca e Innovazione per le Malattie Mieloproliferative AOU Careggi Intro
More informationMDS/MPN MPN MDS. Discolosures. Advances in the Diagnosis of Myeloproliferative Neoplasms. Myeloproliferative neoplasms
Discolosures Advances in the Diagnosis of Myeloproliferative Neoplasms Consulting income from Promedior, Inc. Robert P Hasserjian, MD Associate Professor Massachusetts General Hospital and Harvard Medical
More informationNew WHO Classification of Myeloproliferative Neoplasms
New WHO Classification of Myeloproliferative Neoplasms Hans Michael Kvasnicka Senckenberg Institute of Pathology, University of Frankfurt, Germany hans-michael.kvasnicka@kgu.de Principles and rationale
More informationEssential thrombocythemia treatment algorithm 2018
Tefferi et al. (2018) 8:2 DOI 10.1038/s41408-017-0041-8 CURRENT TREATMENT ALGORITHM Essential thrombocythemia treatment algorithm 2018 Ayalew Tefferi 1, Alessandro M. Vannucchi 2 and Tiziano Barbui 3 Open
More informationShould Mutational Status in Primary Myelofibrosis (PMF) Guide Therapy..YES!!!
Should Mutational Status in Primary Myelofibrosis (PMF) Guide Therapy..YES!!! Lindsay Anne Magura Rein, MD Division of Hematologic Malignancies and Cellular Therapy/BMT A Little Bit of History.. 1665 Advanced
More informationDisclosures. Myeloproliferative Neoplasms: A Case-Based Approach. Objectives. Myeloproliferative Neoplasms. Myeloproliferative Neoplasms
Myeloproliferative Neoplasms: A Case-Based Approach Disclosures No conflicts of interests regarding the topic being presented Adam M. Miller, MD PGY-4 Resident Physician Department of Pathology and Laboratory
More informationApproaching myeloid neoplasms: diagnostic algorithms
Approaching myeloid neoplasms: diagnostic algorithms Alexandar Tzankov Histopathology Pathology Content Integration of clinical and laboratory data Bone marrow evaluation approaching Myeloproliferative
More informationMyeloproliferative Neoplasms and Treatment Overview
Myeloproliferative Neoplasms and Treatment Overview George Nesr Clinical Research Fellow in Haematology Haematology Department Imperial College Healthcare NHS Trust Overview Historical Background Pathogenesis
More informationThe 2008 World Health Organization Classification System for Myeloproliferative Neoplasms
Review Article The 2008 World Health Organization Classification System for Myeloproliferative Neoplasms Order Out of Chaos Ayalew Tefferi, MD 1 ; Juergen Thiele, MD 2 ; and James W. Vardiman, MD 3 The
More informationCharacterization of MPL-mutated myeloid neoplasms: a review of 224 MPL+ cases
Article Characterization of MPL-mutated myeloid neoplasms: a review of 224 MPL+ cases Keming Lin 1,*, Gang Xu 1, Jie-Gen Jiang 1, Mayuko Imai 1, Zhao Wu 1, Paris Petersen 1, Kim Janatpour 1, and Bashar
More informationStifel Nicolaus 2013 Healthcare Conference. John Scarlett, M.D. Chief Executive Officer September 11, 2013
Stifel Nicolaus 2013 Healthcare Conference John Scarlett, M.D. Chief Executive Officer September 11, 2013 1 forward-looking statements Except for the historical information contained herein, this presentation
More informationLondon Cancer. Myelofibrosis guidelines. August Review August Version v1.0. Page 1 of 12
London Cancer Myelofibrosis guidelines August 2013 Review August 2013 Version v1.0 Page 1 of 12 CONTENTS 1. DIAGNOSIS... 3 1a. BCSH (2012)... 3 1b. WHO (2009) diagnostic criteria for PMF:... 4 2. MOLECULAR
More informationPolycythemia Vera and other Myeloproliferative Neoplasms. A.Mousavi
Polycythemia Vera and other Myeloproliferative Neoplasms A.Mousavi Chronic MPNs Multipotent hematopoietic progenitor cell is origin. Overproduction of one or more formed element of blood cells without
More informationPractical Considerations in the Treatment Myeloproliferative Neoplasms: Prognostication and Current Treatment Indy Hematology
Practical Considerations in the Treatment Myeloproliferative Neoplasms: Prognostication and Current Treatment Indy Hematology Angela Fleischman MD PhD UC Irvine March 9, 2019 Disclosures: Angela Fleischman
More informationTechnical Bulletin No. 100
CPAL Central Pennsylvania Alliance Laboratory Technical Bulletin No. 100 August 2, 2012 JAK2 AND MPL 515 MUTATIONAL ANALYSIS Contact: Dr. Jeffrey Wisotzkey, 717-851-1422 Technical Director, CPAL Jill A.
More informationTemplate for Reporting Results of Biomarker Testing for Myeloproliferative Neoplasms
Template for Reporting Results of Biomarker Testing for Myeloproliferative Neoplasms Version: MPNBiomarkers 1.0.0.2 Protocol Posting Date: June 2017 This biomarker template is NOT required for accreditation
More informationEmerging diagnostic and risk stratification criteria
PV STATE OF MIND Polycythemia vera: Emerging diagnostic and risk stratification criteria Rami S. Komrokji, MD Moffitt Cancer Center, Tampa, Florida Disclosure These slides were developed by Incyte Corporation
More informationCME Information: Primary myelofibrosis: 2017 update on diagnosis, risk-stratification and management
CME ARTICLE AJH CME Information: Primary myelofibrosis: 2017 update on diagnosis, risk-stratification and management CME Editor: Ayalew Tefferi, M.D. Author: Ayalew Tefferi, M.D. If you wish to receive
More informationMyelodysplastic/Myeloproliferative Neoplasms (MDS/MPN) Updated
Myelodysplastic/Myeloproliferative Neoplasms (MDS/MPN) Updated Attilio Orazi, MD, FRCPath. (Engl.) Professor of Pathology and Laboratory Medicine Weill Cornell Medical College/NYP Hospital New York, NY
More informationRelated Policies None
Medical Policy MP 2.04.60 BCBSA Ref. Policy: 2.04.60 Last Review: 07/25/2018 Effective Date: 07/25/2018 Section: Medicine Related Policies None DISCLAIMER Our medical policies are designed for informational
More informationDiagnostic Approach for Eosinophilia and Mastocytosis. Curtis A. Hanson, M.D.
Diagnostic Approach for Eosinophilia and Mastocytosis Curtis A. Hanson, M.D. 2014 MFMER slide-1 DISCLOSURES: Relevant Financial Relationship(s) None Off Label Usage None 2014 MFMER slide-2 Molecular Classification
More informationASBMT MDS/MPN Update Sunil Abhyankar, MD
ASBMT MDS/MPN Update Sunil Abhyankar, MD Professor of Medicine Medical Director, Pheresis and Cell Processing Division of Hematologic Malignancies and Cellular Therapeutics Department of Internal Medicine
More informationPrognostic models in PV and ET
Prognostic models in PV and ET Francesco Passamonti Hematology, Varese, Italy Current risk stratification in PV and ET: statement from European LeukemiaNet consensus Age over 60 years Previuos thrombosis
More informationWinship Cancer Institute of Emory University New Determinants and Approaches for MPN
Winship Cancer Institute of Emory University New Determinants and Approaches for MPN Elliott F. Winton August 8, 2014 Sea Island, Georgia Outline: MPN Determinants, Approaches Diagnosis Prognosis Treatment
More informationBone marrow histopathology in Ph - CMPDs. - the new WHO classification - Juergen Thiele Cologne, Germany
Bone marrow histopathology in Ph - CMPDs - the new WHO classification - Juergen Thiele Cologne, Germany Current issues in MPNs concerning morphology 1.Prodromal stages of disease 2.Impact of histopathology
More informationHow I Treat Myelofibrosis. Adam Mead, MD, PhD University of Oxford Oxford, United Kingdom
How I Treat Myelofibrosis Adam Mead, MD, PhD University of Oxford Oxford, United Kingdom Primary Myelofibrosis Archiv Fur Pathol. 1879;78:475-96. 2 cases of leukemia with peculiar blood and marrow findings
More informationShould Mutation Status in PMF Guide Therapy? No! Brady L. Stein, MD MHS Assistant Professor of Medicine Division of Hematology/Oncology
Should Mutation Status in PMF Guide Therapy? No! Brady L. Stein, MD MHS Assistant Professor of Medicine Division of Hematology/Oncology Case presentation A 67 yo woman presents to transition care, as her
More informationPost-ASH 2015 CML - MPN
Post-ASH 2015 CML - MPN Fleur Samantha Benghiat, MD, PhD Hôpital Erasme, Brussels 09.01.2016 1. CML CML 1st line ttt Prognosis Imatinib Nilotinib Response Discontinuation Dasatinib Low RISK PROFILE High
More informationMayo alliance prognostic system for mastocytosis: clinical and hybrid clinical-molecular models
REGULAR ARTICLE Mayo alliance prognostic system for mastocytosis: clinical and hybrid clinical-molecular models Animesh Pardanani, 1 Sahrish Shah, 1 Francesco Mannelli, 2 Yoseph C. Elala, 1 Paola Guglielmelli,
More informationJAK2 Inhibitors for Myeloproliferative Diseases
JAK2 Inhibitors for Myeloproliferative Diseases Srdan (Serge) Verstovsek M.D., Ph.D. Associate Professor Department of Leukemia University of Texas MD Anderson Cancer Center Houston, Texas, USA Myeloproliferative
More informationGuidelines for diagnosis and management of adult myeloproliferative neoplasms (PV, ET, PMF and HES)
Guidelines for diagnosis and management of adult myeloproliferative neoplasms (PV, ET, PMF and HES) Author: Dr N Butt, Consultant Haematologist On behalf of the Haematology CNG Written: July 2010 Reviewed:
More informationCase Presentation. Attilio Orazi, MD
Case Presentation Attilio Orazi, MD Weill Cornell Medical College/ NYP Hospital Department of Pathology and Laboratory Medicine New York, NY United States History 60 year old man presented with anemia
More informationMolecular aberrations in MPN. and use in the clinic. Timothy Devos MD PhD
Molecular aberrations in MPN and use in the clinic Timothy Devos MD PhD MB&C2017 24-3-2017 Introduction 1951: William Dameshek MPD MPN = clonal, hematopoietic stem cell disorders, proliferation in BM of
More informationThe Internists Approach to Polycythemia and Implications of Uncontrolled Disease
The Internists Approach to Polycythemia and Implications of Uncontrolled Disease Mary Jo K. Voelpel, DO, FACOI, MA, CS Associate Clinical Professor MSU-COM Disclosures NONE Overview 1. Objectives 2. Case
More informationStifel Healthcare Conference John Scarlett, M.D. Chief Executive Officer November 19, 2014
Stifel Healthcare Conference 2014 John Scarlett, M.D. Chief Executive Officer November 19, 2014 1 forward-looking statements Except for statements of historical fact, the statements during this presentation
More informationHeme 9 Myeloid neoplasms
Heme 9 Myeloid neoplasms The minimum number of blasts to diagnose acute myeloid leukemia is 5% 10% 20% 50% 80% AML with the best prognosis is AML with recurrent cytogenetic abnormality AML with myelodysplasia
More informationCLINICAL POLICY DEPARTMENT: Medical Management DOCUMENT NAME: JakafiTM REFERENCE NUMBER: NH.PHAR.98
PAGE: 1 of 6 IMPORTANT REMINDER This Clinical Policy has been developed by appropriately experienced and licensed health care professionals based on a thorough review and consideration of generally accepted
More informationASH 2014 Analyst & Investor Event
ASH 2014 Analyst & Investor Event December 8, 2014 John A. Scarlett, M.D. President & CEO, Geron Corporation Steven Lane, M.D., Ph.D. Queensland Institute of Medical Research Forward-Looking Statements
More informationUnderstanding Your Blood Work Results
Understanding Your Blood Work Results Carlos Besses, MD, hd Hematology Department Hospital del Mar - IMIM, Barcelona Carlos Besses Disclosures Novartis Honorarium Speaker Shire Honorarium Speaker Galena
More informationPiper Jaffray Healthcare Conference
Piper Jaffray Healthcare Conference John Scarlett, M.D. President and CEO, Geron Corporation November 2018 Forward-Looking Statements Except for statements of historical fact, the statements contained
More informationUpdate in Myeloproliferative Neoplasms
Update in Myeloproliferative Neoplasms 2018 UPDATE IN HEMATOLOGIC MALIGNANCIES January 26, 2018 Daria Babushok, MD PhD Learning Objectives Philadelphia-chromosome negative MPNs 1. To review key changes
More informationNON-CLASSIC MYELOPROLIFERATIVE NEOPLASMS: ARE WE REALLY AWARE OF THESE RARE DISEASES IN DAILY PRACTICE?
NON-CLASSIC MYELOPROLIFERATIVE NEOPLASMS: ARE WE REALLY AWARE OF THESE RARE DISEASES IN DAILY PRACTICE? *Serdal Korkmaz Department of Hematology, Kayseri Training and Research Hospital, Kayseri, Turkey
More informationTemplate for Reporting Results of Biomarker Testing for Myeloproliferative Neoplasms
Template for Reporting Results of Biomarker Testing for Myeloproliferative Neoplasms Template web posting date: December 2014 Authors Todd W. Kelley, MD, FCAP University of Utah and ARUP Laboratories,
More informationMutational Analysis of EXON 9 of the CALR Gene (Reference )
Mutational Analysis of EXON 9 of the CALR Gene (Reference 2014.01.002) Notice of Assessment June 2014 DISCLAIMER: This document was originally drafted in French by the Institut national d'excellence en
More informationVolume 28, Issue 4 Fall 2018 eissn:
Volume 28, Issue 4 Fall 2018 eissn: 2368-8076 Myeloproliferative neoplasms (MPNs) Part 1: An overview of the diagnosis and treatment of the classical MPNs by Sabrina Fowlkes, Cindy Murray, Adrienne Fulford,
More informationMutaciones y sus implicancias clínicas en neoplasias mieloproliferativas
Mutaciones y sus implicancias clínicas en neoplasias mieloproliferativas Genetics and prognosis in myeloproliferative neoplasms Guglielmelli P, Rotunno G, Pacilli A, Vannucchi AM NEOPLASIAS MIELOPROLIFERATIVAS
More informationMyeloproliferative Disorders in the Elderly: Clinical Presentation and Role of Bone Marrow Examination
Myeloproliferative Disorders in the Elderly: Clinical Presentation and Role of Bone Marrow Examination Arati V. Rao, M.D. Division of Medical Oncology and Geriatrics Duke University Medical Center Durham
More informationLatest updates in Myeloproliferative Neoplasms. Elizabeth Hexner, MD, MSTR
Latest updates in Myeloproliferative Neoplasms Elizabeth Hexner, MD, MSTR Disclosures Nothing to disclose Agenda/Goals Treatment goals in PV Indications for cytoreduction in patients polycythemia vera
More informationThe myeloproliferative neoplasms, unclassifiable: clinical and pathological considerations
2017 USCAP, Inc All rights reserved 0893-3952/17 $32.00 169 The myeloproliferative neoplasms, unclassifiable: clinical and pathological considerations Umberto Gianelli 1, Daniele Cattaneo 2, Anna Bossi
More informationMielofibrosi: inquadramento dei fattori prognostici
Mielofibrosi: inquadramento dei fattori prognostici Francesco Passamon, Division of Hematology University Hospital, Fondazione Macchi Varese, Italy Reduced survival in PMF and causes of death Median OS
More information"Calreticulin Mutation Analysis in Iranian patients suffering from Essential thrombocythemia and Primary Myelofibrosis
"Calreticulin Mutation Analysis in Iranian patients suffering from Essential thrombocythemia and Primary Myelofibrosis Dr Behzad Poopak, DCLS PhD. Associate professor of fhematology Islamic Azad University
More informationPrimary myelofibrosis (PMF) is a hematologic malignancy
Brief Report Mature Survival Data for 176 Patients Younger Than With Primary Myelofibrosis Diagnosed Between 1976 and 5: Evidence for Survival Gains in Recent Rakhee Vaidya, MBBS; Sergio Siragusa, MD;
More informationMALATTIE MIELOPROLIFERATIVE CRONICHE
MALATTIE MIELOPROLIFERATIVE CRONICHE Dott. Roberto Latagliata Policlinico Umberto I Università Sapienza, Roma Highlights from EHA 2017: some points to address today WHO 2016 MPN classification: hot topics
More informationIntegrated Diagnostic Approach to the Classification of Myeloid Neoplasms. Daniel A. Arber, MD Stanford University
Integrated Diagnostic Approach to the Classification of Myeloid Neoplasms Daniel A. Arber, MD Stanford University What is an integrated approach? What is an integrated approach? Incorporating all diagnostic
More informationPatient Case Studies & Panel Discussion Myeloproliferative Disorders, Elderly Myelofibrosis, Hemophagocytic Syndromes
Patient Case Studies & Panel Discussion Myeloproliferative Disorders, Elderly Myelofibrosis, Hemophagocytic Syndromes Panelists: Jessica Altman, MD, Robert H. Lurie Comprehensive Cancer Center of Northwestern
More informationPolycytemia Vera, Essential Thrombocythemia and Myelofibrosis: prognosis and treatment
Polycytemia Vera, Essential Thrombocythemia and Myelofibrosis: prognosis and treatment BHS Training course 2013-2015 Timothy Devos POLYCYTEMIA VERA PV: clinical manifestations thrombosis (art > ven) facial
More informationTargeted next-generation sequencing in blast phase myeloproliferative neoplasms
REGULAR ARTICLE Targeted next-generation sequencing in blast phase myeloproliferative neoplasms Terra L. Lasho, Mythri Mudireddy, Christy M. Finke, Curtis A. Hanson, Rhett P. Ketterling, Natasha Szuber,
More informationShould Intermediate-I risk PMF be transplanted immediately or later? Position: Later
Should Intermediate-I risk PMF be transplanted immediately or later? Position: Later Vikas Gupta, MD, FRCP, FRCPath Associate Professor Department of Medicine Leukemia/BMT Programs Princess Margaret Cancer
More informationSH A CASE OF PERSISTANT NEUTROPHILIA: BCR-ABL
SH2017-0124 A CASE OF PERSISTANT NEUTROPHILIA: BCR-ABL NEGATIVE John R Goodlad 1, Pedro Martin-Cabrera 2, Catherine Cargo 2 1. Department of Pathology, NHS Greater Glasgow & Clyde, QEUH, Glasgow 2. Haematological
More informationHistological evaluation of myeloproliferative neoplasms
Journal of clinical and experimental hematopathology Vol. 58 No.2, 45-50, 2018 JC lin EH xp ematopathol Review Article Histological evaluation of myeloproliferative neoplasms Hideyo Fujiwara In 2017, the
More informationMyeloid neoplasms. Early arrest in the blast cell or immature cell "we call it acute leukemia" Myoid neoplasm divided in to 3 major categories:
Myeloid neoplasms Note: Early arrest in the blast cell or immature cell "we call it acute leukemia" Myoid neoplasm divided in to 3 major categories: 1. AML : Acute myeloid leukemia(stem cell with myeloid
More informationNew Therapies for MPNs
Pomalidomide and IMIDS in Myelofibrosis New Therapies for MPNs Fourth International Workshop on CML and MPN Natchez Louisiana Ruben A. Mesa, MD Professor of Medicine Mayo Clinic College of Medicine Director
More informationMDS/MPN: What it is and How it Should be Treated?
MDS/MPN: What it is and How it Should be Treated? MDS MPN Rachel Salit, MD Assistant Member Fred Hutchinson Cancer Research Center rsalit@fredhutch.org MDS Founda>on Pa>ent & Family Forum: May 20, 2017
More informationMyelodysplastic syndrome (MDS) & Myeloproliferative neoplasms
Myelodysplastic syndrome (MDS) & Myeloproliferative neoplasms Myelodysplastic syndrome (MDS) A multipotent stem cell that can differentiate into any of the myeloid lineage cells (RBCs, granulocytes, megakaryocytes)
More informationHow to monitor MPN patients
How to monitor MPN patients MPN carries significant burden and risk Transformation to MF or AML 1 Neurological complications 2 MPN-associated general symptoms (eg, pruritus, fatigue) 3 Microvascular symptoms
More informationPolycythemia Vera: Aligning Real-World Practices With Current Best Practices
Polycythemia Vera: Aligning Real-World Practices With Current Best Practices Overview Ruben A. Mesa, MD, provides practical insights into treating polycythemia vera. In addition to discussing risk stratification,
More informationWHO Classification of Myeloid Neoplasms with Defined Molecular Abnormalities
WHO Classification of Myeloid Neoplasms with Defined Molecular Abnormalities Robert W. McKenna, M.D. 1/2009 WHO Classification of Myeloid Neoplasms (4th Edition)--2008 Incorporates new information that
More informationJAKAFI (ruxolitinib phosphate) oral tablet
JAKAFI (ruxolitinib phosphate) oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy
More informationChronic Idiopathic Myelofibrosis (CIMF)
Chronic Idiopathic Myelofibrosis (CIMF) CIMF Synonyms Agnogenic myeloid metaplasia Myelosclerosis with myeloid metaplasia Chronic granulocytic-megakaryocytic myelosis CIMF Megakaryocytic proliferation
More informationJ Clin Oncol 29: by American Society of Clinical Oncology INTRODUCTION
VOLUME 29 NUMBER 4 FEBRUARY 1 11 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T DIPSS Plus: A Refined Dynamic International Prognostic Scoring System for Primary Myelofibrosis That Incorporates
More informationCurrent Prognostication in Primary Myelofibrosis
Current Prognostication in Primary Myelofibrosis Francisco Cervantes Hematology Department, Hospital Clínic, Barcelona, Spain Florence, April 2011 Survival in PMF No. patients: 1,054 Median Srv (95% CI):
More informationGreater Manchester and Cheshire Cancer Network
Greater Manchester and Cheshire Cancer Network Guidelines for the diagnosis and treatment of primary myelofibrosis, post-essential thrombocythaemia myelofibrosis and post-polycythaemia myelofibrosis Tim
More informationPhiladelphia chromosome-negative chronic myeloproliferative neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Annals of Oncology 26 (Supplement 5): v85 v99, 2015 doi:10.1093/annonc/mdv203 Published online 4 August 2015 Philadelphia chromosome-negative chronic myeloproliferative neoplasms: ESMO Clinical Practice
More informationMyeloproliferative Neoplasms
Myeloproliferative Neoplasms C O N T E M P O R A R Y H E M AT O L O G Y Judith E. Karp, MD, Series Editor For other titles published in this series, go to www.springer.com/series/7681 Myeloproliferative
More information