Panel Discusses Key Diagnostic Standards for Myelofibrosis

By Ruben Mesa, MD, Naveen Pemmaraju, MD, Sanam Loghavi, MD, Olatoyosi Odenike, MD - Last Updated: June 7, 2024

A roundtable discussion, moderated by Ruben Mesa, MD, of the Atrium Health Wake Forest Baptist Comprehensive Cancer Center, focused on the latest updates in myeloproliferative neoplasms. Dr. Mesa was joined by Naveen Pemmaraju, MD, of the University of Texas MD Anderson Cancer Center; Sanam Loghavi, MD, of the MD Anderson Cancer Center; and Olatoyosi Odenike, MD, of the University of Chicago Medicine.

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In the first segment of the roundtable series, the panel discusses how myelofibrosis (MF) is diagnosed and assessed in modern medical practice.

Dr. Mesa: What is the key diagnostic standard for MF in terms of testing?

Dr. Loghavi: Being a traditional morphologist at heart, I think morphologic evaluation of the bone marrow is critical. With a bone marrow aspiration and a biopsy comes traditional conventional karyotyping. We need to risk stratify patients molecularly at baseline. A basic myeloid next generation sequencing (NGS) panel is necessary. With some of the newer techniques, we’ve started doing optical genome mapping to detect cryptic abnormalities that we may not detect on traditional conventional carrier typing.

Dr. Mesa: Do you feel the need to do any imaging to objectify the size of the spleen?

Dr. Odenike: No, we do not do any imaging to objectify the size of the spleen. We only do imaging of the spleen if the patient has symptoms. Usually, splenomegaly is not a subtle finding. A good clinician can figure that out at the bedside.

We will often use human leukocyte antigen typing at the time of presentation, knowing that allogeneic stem cell transplant is the only path to a cure. Until proven otherwise, a diagnosis of MF may render a patient potentially eligible for an allogeneic stem cell transplant.

Post Tags:HOPLive24-MPN
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