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Does Developing an MPN at an Early Age Affect Progression?

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Published on October 15, 2015

In this Ask the Expert segment, Dr. Jason Gotlib from Stanford Cancer Institute responds to Amanda’s question, “Is there any information about patients that develop MPNs early in life and how this may affect their progression?”  Dr. Gotlib shares his insights related to age and MPNs, how there is still much research to be done, and why he is hopeful.

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Transcript | Does Developing an MPN at an Early Age Affect Progression?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.       

Andrew Schorr:

Dr. Gotlib, here's a question we got in from Amanda in Wallingford, Connecticut.  She says, “Is there any information about patients that develop MPNs early in life and how this may affect their progression, if any progression happens?”  For example, she said, “I was diagnosed when I was just 24.  Does this make me more at risk to progress to a more serious form of cancer?”  

Dr. Gotlib:

I think that's a very good question.  And I think that there's still a lot to be learned about why there are certain individuals that may be diagnosed with an MPN at an early age.  What I would say is that when you look at the natural history of MPNs, such as polycythemia vera or essential thrombocythemia or myelofibrosis, we know that their survival is less than age-matched controls.  And if you look at the prognosis of patients with a PV versus ET versus myelofibrosis, the individuals that generally speaking have the survival that is most near age-matched controls is patients with ET and then perhaps less so PV and then less so more than that is myelofibrosis. 

We do know that there are certain inherited variations in one's DNA that does lend some increased risk, albeit very small increased risk, such that there might be an increased risk of developing MPNs within families.  So if someone has these increased susceptibilities, if the incidence of the myeloproliferative neoplasm is for example two cases per 100,000, these inherited variations may increase the risk to six to eight in 100,000. 

Now, getting back to Amanda's question about what lies ahead of her, what I would say is that with younger patients since they have more years ahead of them to develop something, because most individuals with an MPN are perhaps age 60, developing more advanced disease may not happen in the one or two decades that lie ahead of them.  In contrast, if someone is younger, perhaps in their 20s or 30s, with five or six decades ahead of them, there may be more time for, for example, PV to move to myelofibrosis or ET to move to myelofibrosis.  So with more time ahead of you, you're giving essentially more time for the natural history to declare itself. 

Andrew Schorr:

Okay.  But we're also giving you more time to develop better treatments.  

Dr. Gotlib:

That's correct.  And so that's an incredibly important point.  So every five or 10 years, we're doing better in terms of our supportive care for patients.  We're getting new classes of drugs, and so in that regard I'm very hopeful that that's going to help someone like Amanda, because we're doing better and better every year.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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