Preview

Oncohematology

Advanced search

Primary myelofibrosis: own experience and news from diagnostic and treatment

https://doi.org/10.17650/1818-8346-2015-10-2-26-36

Abstract

The newest advances in primary myelofibrosis (PMF) pathogenesis study, diagnostic and treatment approaches are presented in this article. The JAK-STAT signal pathway activation now recognized as main pathogenesis mechanism of PMF, it caused by JAK2, CALR, MPL genes mutations. Authors demonstrate their own data about epidemiology, clinical signs, diagnostic and treatment results of 315 PMF patients. The most frequent clinical symptoms are: anemia, leukocytosis, thrombocytosis, splenomegaly, constitutional symptoms. Diagnostic criteria, prognostic scales (including cytogenetic and molecular features) issues are reviewed. Intermediate-1 risk grade is in the most proportion of patients. The
recommended PMF treatment algorithm is listed. The treatment methods, target drugs (Janus kinases inhibitors) trials results are discussed.

About the Authors

K. M. Abdulkadyrov
Russian Research Institute of Hematology and Transfusiology, Federal Medical and Biological Agency; 16, 2 nd Sovetskaya St., St. Petersburg, 191024, Russia
Russian Federation


V. A. Shuvaev
Russian Research Institute of Hematology and Transfusiology, Federal Medical and Biological Agency; 16, 2 nd Sovetskaya St., St. Petersburg, 191024, Russia
Russian Federation


I. S. Martynkevich
Russian Research Institute of Hematology and Transfusiology, Federal Medical and Biological Agency; 16, 2 nd Sovetskaya St., St. Petersburg, 191024, Russia
Russian Federation


References

1. Heuck G. Fälle von Leukämie mit eigenthümlichem Blut-resp Knochenmarksbefund. Virchows Arch (Pathol Anat) 1879;78.

2. Mesa R. A. How I treat symptomatic splenomegaly in patients with myelofibrosis. Blood 2009;113(22):5394–400.

3. Dameshek W. Some speculations on the myeloproliferative syndromes. Blood 1951;6(4):372–5.

4. Абдулкадыров К. М., Блинов М. Н., Щербакова Е. Г. и др. Дифференциальная диагностика идиопатического миелофиброза и хронического миелолейкоза. Л., 1985. 26 с. [Abdulkadyrov K. M., Shcherbakova E. G. et al. Differential diagnosis of idiopathic myelofibrosis and chronic myeloid leukemia. L., 1985. 26 pp. (In Russ.)].

5. Абдулкадыров К. М. Клиническая гематология: справочник. СПб.: Питер-Принт СПб, 2006. 447 с. [Abdulkadyrov K. M. Clinical hematology: a handbook. St. Petersburg: Piter: Piter-Print SPb, 2006. 447 pp. (In Russ.)].

6. Абдулкадыров К. М. Хронический лейкозретикулоз (некоторые вопросы патогенеза, клиники и лечения). Автореф. Дис. ... д-ра мед. наук. Л., 1973. 35 с. [Abdulkadyrov K. M. Chronic leukemiaretikulosis (some questions of pathogenesis, clinical picture and treatment). Dissert. D. Sci. L., 1973. 35 pp. (In Russ.)].

7. Абдулкадыров К. М., Шуваев В. А., Мартынкевич И. С. Критерии диагностики и современные методы лечения первичного миелофиброза. Вестник гематологии 2013;9(3):44–78.

8. [Abdulkadyrov K. M., Shuvaev V. A., Martynkevich I. S. Diagnostic criteria and current treatment of primary myelofibrosis. Vestnik gematologii = Bulletin of Hematology 2013;9(3):44–78. (In Russ.)].

9. Vannucchi A. M. Management of myelofibrosis. ASH Education Program Book 2011;2011(1):222–30.

10. Shuvaev V., Abdulkadyrova A., Udaleva V. et al. Primary myelofibrosis – a survey based on the 20-years, experience of a single center. Haematologica 2013;98(Suppl. 1, June 2013):624.

11. Rollison D. E., Howlader N., Smith M. T. et al. Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001–2004, using data from the NAACCR and SEER programs. Blood 2008;112(1):45–52.

12. Levine R. L., Wadleigh M., Cools J. et al. Activating mutation in the tyrosine kinase JAK2 in polycythemia vera, essential thrombocythemia, and myeloid metaplasia with myelofibrosis. Cancer Cell;7(4):387–97.

13. Martyré M. C. Critical review of pathogenetic mechanisms in myelofibrosis with myeloid metaplasia. Curr Hematol Rep 2003;2(3):257–63.

14. Vannucchi A. M., Guglielmelli P. Molecular pathophysiology of Philadelphianegative myeloproliferative disorders: beyond JAK2 and MPL mutations. Haematologica 2008;93(7):972–6.

15. Tefferi A., Thiele J., Vannucchi A. M., Barbui T. An overview on CALR and CSF3R mutations and a proposal for revision of WHO diagnostic criteria for myeloproliferative neoplasms. Leukemia 2014;28(7):1407–13.

16. Tefferi A., Solberg L. A., Silverstein M. N. A clinical update in polycythemia vera and essential thrombocythemia. Am J Med 2000;109(2):141–9.

17. Klampfl T., Gisslinger H., Harutyunyan A. S. et al. Somatic mutations of calreticulin in myeloproliferative neoplasms. N Engl J Med 2013;369(25):2379–90.

18. Nangalia J., Massie C. E., Baxter E. J. et al. Somatic CALR mutations in myeloproliferative neoplasms with nonmutated JAK2. N Engl J Med 2013;369(25):2391–405.

19. Tefferi A. Pathogenesis of myelofibrosis with myeloid metaplasia. J Clin Oncol 2005;23(33):8520–30.

20. Cho S. Y., Xu M., Roboz J. et al. The Effect of CXCL12 processing on CD34+ cell migration in myeloproliferative neoplasms. Cancer Res 2010;70(8):3402–10.

21. Schmitt A., Jouault H., Guichard J. et al. Pathologic interaction between megakaryocytes and polymorphonuclear leukocytes in myelofibrosis. Blood 2000;96(4):1342–7.

22. Massa M., Rosti V., Ramajoli I. et al. Circulating CD34+, CD133+, and vascular endothelial growth factor receptor 2 –positive endothelial progenitor cells in myelofibrosis with myeloid metaplasia. J Clin Oncol 2005;23(24):5688–95.

23. Verstovsek S., Kantarjian H., Mesa R. A. et al. Safety and efficacy of INCB018424, a JAK1 and JAK2 inhibitor, in myelofibrosis. N Engl J Med 2010;363(12):1117–27.

24. Tefferi A., Vaidya R., Caramazza D. et al. Circulating interleukin(IL) – 8, IL-2R, IL- 12, and IL-15 levels are independently prognostic in primary myelofibrosis: a comprehensive cytokine profiling study. J Clin Oncol 2011;29(10):1356–63.

25. Barbui T., Barosi G., Birgegard G. et al. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. J Clin Oncol 2011;29(6):761–70.

26. Tefferi A. Primary myelofibrosis: 2013 update on diagnosis, risk-stratification, and management. Am J Hematol 2013;88(2):141–50.

27. Tefferi A., Thiele J., Orazi A. et al. Proposals and rationale for revision of the World Health Organization diagnostic criteria for polycythemia vera, essential thrombocythemia, and primary myelofibrosis: recommendations from an ad hoc international expert panel. Blood 2007;110(4):1092–7.

28. Vardiman J. W., Thiele J., Arber D. A. et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood 2009;114(5):937–51.

29. Thiele J., Kvasnicka H. M., Facchetti F. et al. European consensus on grading bone marrow fibrosis and assessment of cellularity. Haematologica 2005;90(8):1128–32.

30. Cervantes F., Dupriez B., Pereira A. et al. New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood 2008;113(13):2895–901.

31. Passamonti F., Cervantes F., Vannucchi A. M. et al. A dynamic prognostic model to predict survival in primary myelofibrosis: a study by the IWG-MRT (International Working Group for Myeloproliferative Neoplasms Research and Treatment). Blood 2009;115(9):1703–8.

32. Tefferi A., Siragusa S., Hussein K. et al. Transfusion-dependency at presentation and its acquisition in the first year of diagnosis are both equally detrimental for survival in primary myelofibrosis – prognostic relevance is independent of IPSS or karyotype. Am J Hematol 2010;85(1):14–7.

33. Patnaik M. M., Caramazza D., Gangat N. et al. Age and platelet count are IPSS-independent prognostic factors in young patients with primary myelofibrosis and complement IPSS in predicting very long or very short survival. Eur J Haematol 2010;84(2):105–8.

34. Hussein K., Pardanani A. D., Van Dyke D. L. et al. International Prognostic Scoring System – independent cytogenetic risk categorization in primary myelofibrosis. Blood 2009;115(3):496–9.

35. Gangat N., Caramazza D., Vaidya R. et al. DIPSS plus: a refined dynamic international prognostic scoring system for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count, and transfusion status. J Clin Oncol 2011;29(4):392–7.

36. Vannucchi A. M., Guglielmelli P., Rotunno G. et al. Mutation-Enhanced International Prognostic Scoring System (MIPSS) for primary myelofibrosis: an AGIMM & IWG-MRT project. Blood 2014;(56th ASH Annual Meeting and Exposition, San-Francisco, December 6–9, 2014):P405.

37. Tefferi A. How I treat myelofibrosis. Blood 2011;117(13):3494–504.

38. Huang J., Tefferi A. Erythropoiesis stimulating agents have limited therapeutic activity in transfusion-dependent patients with primary myelofibrosis regardless of serum erythropoietin level. Eur J Haematol 2009;83(2):154–5.

39. Yacoub A., Odenike O., Verstovsek S. Ruxolitinib: long-term management of patients with myelofibrosis and future directions in the treatment of myeloproliferative neoplasms. Curr Hematol Malig Rep 2014;9(4):350–9.

40. Cervantes F., Vannucchi A. M., Kiladjian J.-J. et al. Three-year efficacy, safety, and survival findings from COMFORT-II, a phase 3 study comparing ruxolitinib with best available therapy for myelofibrosis. Blood 2013;122(25):4047–53.

41. Verstovsek S., Mesa R. A., Gotlib J. et al. A double-blind, placebo-controlled trial of ruxolitinib for myelofibrosis. N Engl J Med 2012;366(9):799–807.

42. Шуваев В. А., Мартынкевич И. С., Абдулкадыров К. М. Клинические и экономические преимущества применения руксолитиниба по сравнению с традиционной терапией при лечении миелофиброза. Практическая армакоэкономика. Том II. Онкология, онкогематология, психоневрология, ревматология, гинекология, бронхопульмонология, гастроэнтерология, трансплантология (научный сборник). М.: Фарм Медиа, 2013. С. 77–92. [Shuvaev V. A., Martynkevich I. S., Abdulkadyrov K. M. Clinical and economic advantages of ruksolitinib usage compared with traditional myelofibrosis therapy. Practical pharmacoeconomics. Volume II. Oncology, oncohematology, neurology, rheumatology, gynecology, pulmonology, gastroenterology, transplantation (scientific book). M.: Farm Media, 2013. Pp. 77–92 (In Russ.)].

43. Quintás-Cardama A., Verstovsek S. Spleen deflation and beyond: The pros and cons of Janus kinase 2 inhibitor therapy for patients with myeloproliferative neoplasms. Cancer 2012;118(4):870–7.

44. Kassum D., Thomas E. J. Morbidity and mortality of incidental splenectomy. Can J Surg 1977;20:209–14.


Review

For citations:


Abdulkadyrov K.M., Shuvaev V.A., Martynkevich I.S. Primary myelofibrosis: own experience and news from diagnostic and treatment. Oncohematology. 2015;10(2):26-36. (In Russ.) https://doi.org/10.17650/1818-8346-2015-10-2-26-36

Views: 10689


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1818-8346 (Print)
ISSN 2413-4023 (Online)