In this episode of the Oncology Brothers podcast, we dived deep into the complexities of myelofibrosis (MF) as part of our ongoing hematology series. With our guest Dr. Raajit Rampal from the Memorial Sloan Kettering Cancer Center, we discussed the evolving treatment landscape for MF, highlighting recent advancements in symptom management and emerging treatment combinations.
We started by outlining the critical initial workup and diagnostic criteria for suspected myelofibrosis, emphasizing the importance of bone marrow biopsy and next-generation sequencing to identify driver mutations. Dr. Rampal explained how to effectively risk stratify patients using established scoring systems like the IPSS and DIPSS, which takes into account factors such as age, leukocytosis, and anemia.
For symptomatic patients, we explored first-line treatment options, including the use of JAK inhibitors like ruxolitinib, momelotinib, fedratinib, and pacritinib. Dr. Rampal shared insights on how to choose the right treatment based on individual patient characteristics, particularly in cases of anemia and thrombocytopenia. We also discussed the importance of supportive care, including the use of erythropoietin-stimulating agents and the potential role of clinical trials for patients experiencing disease progression.
Throughout the conversation, we stressed the significance of early referral to transplant centers, as stem cell transplant remains the only curative option for myelofibrosis. Dr. Rampal emphasized the need for community oncologists to stay connected with tertiary and quaternary centers to ensure patients have access to the latest treatment options and clinical trials.
In summary, this episode provided a comprehensive overview of the current treatment landscape for myelofibrosis, focusing on diagnosis, risk stratification, treatment options, and the critical role of supportive care.