Current approaches to challenging scenarios in myeloproliferative neoplasms.
The Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia and primary myelofibrosis are clonal hematological malignancies that originate at the level of the hematopoietic stem cell, and are characterized by excessive proliferation of cells belonging to one or more of the myeloid lineages. Central to the pathogenesis of the MPNs is constitutive activation of the JAK/STAT signaling pathway due to a family of driver mutations affecting JAK2, CALR or MPL. These disorders share common clinical and laboratory features, a significant burden of systemic symptoms, increased risk of developing arterial and venous thrombotic events, and the potential to progress to myelofibrosis and acute leukemia. Areas covered: We identified four clinical situations which represent challenging management dilemmas for patients with MPNs. Our conclusions and recommendations are based on a literature search using MEDLINE and recent meeting abstracts using the keywords, focusing on publications directly addressing these scenarios and on recent contributions to the field. Expert commentary: Multi-center efforts to study large cohorts of MPN patients have led to more uniform and evidence-based approaches to key aspects in MPN management. However, treatment strategies to deal with specific clinical scenarios are lacking.
['Zimran|Eran|E|', 'Hoffman|Ronald|R|', 'Kremyanskaya|Marina|M|']
D037282:Calreticulin D006801:Humans D053614:Janus Kinase 2 D053612:Janus Kinases D009154:Mutation D009196:Myeloproliferative Disorders D010677:Philadelphia Chromosome D053628:Receptors, Thrombopoietin D050791:STAT Transcription Factors D015398:Signal Transduction
Myeloproliferative neoplasms polycythemia vera essential thrombocythemia primary myelofibrosis JAK2V617F mutations pregnancy pruritus splanchnic vein thrombosis thrombocytopenia