Published on December 2, 2015
As part of our “Ask the Expert” series, Dr. Jamile Shammo of Rush University Medical Center responds to a Patient Power community member’s question, “What do we know about ET and PV progression to myelofibrosis? Are there any ways progression can be slowed down? What research is being done in this area?”
Transcript | Is It Possible to Slow MPN Progression?
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Andrew Schorr from Patient Power here with our Ask the Expert series in MPNs. I'm with Dr. Jamile Shammo from Rush University Medical Center in Chicago. We have some questions for you.
Here's one, doctor. What do we know about ET and PV progression to myelofibrosis, and are there any ways progression can be slowed down or any research in this area?
That's a great question, because I think that we have variety of treatments of the symptoms, controlled counts, but I wish I could tell you that we have a specific drug that can slow down the disease progression. Now, there are drugs that are being considered to reverse fibrosis, okay? There's a clinical trial going on at MD Anderson with a compound known as PRM-151. So this has been shown to reduce the amount of fibrosis—of course, not to forget about stem cell transplantation because that truly is a curative condition, and it's been shown to result in reversal of fibrosis as well.
But it will be interesting to see if any of those may be—mean again, the antifibrotic medication turn out to be positive in clinical trials. So, yeah, there's research going on in that regard, but I'm not sure that we have a great answer right now.
So when you see a patient, is there any way to tell an ET or PV patient when or if they'll develop myelofibrosis?
I think I monitor my patients very closely for that, and there are certain clues that you can tell whether the patient is or isn't. But I think because this is sort of a chronic condition, with many years of progression until someone develops MF, there are very gray zones. And unless you have a provider that's very cognizant of the signs and symptoms of transformation, it could easily be missed.
So I think it's important to look at the peripheral smear, examine the patient, look at splenomegaly, monitor the anemia progression, leukocytosis, blasts in the peripheral blood, tear drop cells and the like so that you can be—you are aware what you're dealing with.
Okay. All right.