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Managing MPNs: What Is Your Doctor Monitoring at a Checkup?

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Published on January 17, 2017

MPN expert Dr. Srdan Verstovsek of MD Anderson Cancer Center describes how doctors observe trends when monitoring changes and progression in patients with MPNs (myeloproliferative neoplasms). Dr. Verstovsek explains how "you follow the trend in a change" to best understand what is going on with a patient and also put every other factor into perspective.

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Transcript | Managing MPNs: What Is Your Doctor Monitoring at a Checkup?

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. Verstovsek, when do we know when—people—that’s what people worry about, is another shoe going to drop? We know what our situation is now, but we worry whether it’s the medicine failing us or whether something in our body is changing, and then there’s some progression.

How do we—is that just through monitoring? You’re watching different constellation of things?

Dr. Verstovsek: 

In essence, yes. The best you can tell about the person is by monitoring and following the trend—if there is any change—following the trending change. Like with anemia, if the anemia is developing in a patient with ET with high platelets, that would be unusual. You wonder whether it’s because of therapy that the patient is developing, or is it because of the disease itself? So you stop the therapy and see whether anemia resolves. If it continues to worsen, then there is something wrong about it.

Or if the types of cells in the blood are different, the types of white cells, you have bone marrow cells in blood like Dr. Bose mentioned. It could be unusual for patients with ET. But aggressive splenomegaly and to continuously enlarge and become sensitive to touch, that’s unusual.

 

These things usually come hand-to-hand to each other. It’s not one in isolation from the other. That’s why as it was mentioned, the experts in the field came together and devised a criteria again—not one test, a criteria that would say yes the patient is transforming to—from ET to myelofibrosis or PV to myelofibrosis. And the same happens for transformation from myelofibrosis, for example, to acute leukemia. There is a factor there.

So there might be some changes over life, but you have to put it in perspective. Any other change, any therapy, anything else that can happen with the patient—for example, infections or inflammations in the body do change the blood cell count. They do change the size of the spleen in patients with MPN. So we may have slight enlargement on the spleen if you have serious other infection or it’s an acute infection. Take antibiotics, one month later the spleen may be smaller. 

So there are variations. You follow the trend in a change. 

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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