Dear Colleague,

Welcome to the December 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we explore a few key abstracts in the MPN landscape that were presented at the recent 2018 American Society of Hematology Annual Meeting. We also spotlight other MPN research, including the frequency of pulmonary hypertension among this patient population and survival outcomes based on age.

Additionally this month, we explore review articles on new guidelines for the management of complications associated with polycythemia vera, as well as how dose escalation of ruxolitinib impacts the risk of grade 3/4 adverse events.

If you haven’t yet, check out our helpful MPN management resources, including an expert roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case-Based Discussion;” my interview with a patient who has been managing her MPN diagnosis for the past 15 years; and our “Fast Facts” guides with MPN incidence and mortality data and diagnostic criteria.

As always, I hope you find this newsletter and its contents to be a useful and enduring resource in your practice. Please feel free to share it with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Senior Instructor, Blood Cancers and Bone Marrow Transplant Program

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the November 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we highlight two important research articles in the disease state, including study results showing an increased risk of MPN development among smokers and the exciting potential of using prognostic models to personalize clinical outcome predictions in patients with MPNs.

We also spotlight two recent articles on myelofibrosis (MF) reporting the results from a study of ruxolitinib/azacitidine combination therapy and providing an interactive case study of the diagnosis and management of a patient with MF. Additionally this month, we explore the impact of thrombotic events on healthcare costs among patients with polycythemia vera (PV) receiving hydroxyurea and how the use of phlebotomy and hydroxyurea in older patients with PV affects overall survival and thrombosis risk.

Don’t forget about our other handy MPN management resources:

• Our roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case-Based Discussion”
• My interview with Samantha—a patient of mine who has been managing her MPN diagnosis for the past 15 years
• Helpful “Fast Facts” guides with information on MPN incidence and mortality data and World Health Organization diagnostic criteria

As always, I hope you find this newsletter and its contents to be a useful and enduring resource in your practice. Please feel free to share it with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Senior Instructor, Blood Cancers and Bone Marrow Transplant Program

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the October 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we highlight the latest research and discussion on treating and managing polycythemia vera (PV), including the use of cytoreductive therapy for high-risk PV and patient-reported outcomes on symptom burden and quality of life from the REVEAL study. We also explore an overview of combination therapies with potential benefit for patients with ruxolitinib-refractory myelofibrosis (MF), and 12-month follow-up data from the COMBI trial of pegylated interferon alfa-2 plus ruxolitinib in patients with MF or PV. Additionally, we feature a review on the importance of identifying blood clots as a possible early symptom of essential thrombocythemia.

If you haven’t yet, make sure to watch our roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case-Based Discussion,” on the current state of MPN treatment and management. You can also learn more about MPN diagnosis and management by checking out my patient interview and our helpful “fast facts” guides.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Senior Instructor, Blood Cancers and Bone Marrow Transplant Program

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the September 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we highlight two articles on polycythemia vera concerning the role of JAK2 inhibition and cytoreductive therapy. We also explore myelofibrosis news, including ruxolitinib dose escalation to decrease adverse events and the potential of PTX3 plasma levels in determining disease burden. Additionally, we feature news articles on a new tool for patients with myelofibrosis undergoing stem cell transplantation and a study showing an increased risk of disease among relatives of patients with myeloid blood cancers.  

And don’t forget about our other valuable MPN resources:

• Watch me and three experts in the field discuss the current state of MPN treatment and management through three case studies in our roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case-Based Discussion.”
• Learn more about MPN diagnosis and long-term management from the patient perspective in my interview with Samantha—a patient of mine who has been managing her disease for the past 15 years.
• Check out our helpful “fast facts” guides, which provide information on MPN incidence and mortality data and World Health Organization diagnostic criteria.

As always, I hope you find this month’s newsletter insightful and helpful for your everyday practice and beyond.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear colleague,

Welcome to the July 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we highlight MPN research from the recent 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, including trials investigating the role of ruxolitinib and JAK1/2 inhibitor therapies in relation to allogeneic stem cell transplant, and an ongoing study of luspatercept for the treatment of myelofibrosis-induced anemia.

We also explore exciting new data on the relationship between the SOCS1 and JAK proteins and what this means for future MPN therapies. Additionally, we feature an article that proposes an increased risk of aggressive B-cell lymphoma for some patients with myelofibrosis.

If you’re looking to learn more, we have a plethora of other MPN resources to boost your knowledge:

• Watch our full roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case-Based Discussion,” during which three experts in the field and I highlight the current state of MPN treatment and management.
• View my interview with Samantha—a patient of mine who has been managing her disease for the past 15 years—as we chat about her MPN diagnosis and long-term management, the importance of advanced practitioners, and why communication is key.
• Check out our handy “fast facts” guides—helpful and informative PDFs of MPN incidence and mortality data and World Health Organization diagnostic criteria.

I hope you enjoy this month’s newsletter and the enduring MPN resources we’ve created to ensure you take away valuable insights for your practice. 

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the June 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. I’d like to kick things off by presenting my interview with Samantha—a patient of mine who was diagnosed with an MPN at a young age and has been managing her disease for the past 15 years. She and I recently chatted about her MPN diagnosis and long-term management, how advanced practitioners have influenced her care, and why communication is key throughout the entire process. I hope you enjoy our conversation and take away valuable insights from the patient perspective to use in your practice.  

This month, we also provide links to articles on a recent survey about the employment and work productivity of patients with MPNs; a discussion of the diagnostic, prognostic, and treatment implications of mutation profiling for MPNs; and thoughts on the future of genetic profiling for MPNs.

Make sure to check out our full roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case-Based Discussion,” and our “Fast Facts” guides —helpful and informative PDFs of MPN incidence and mortality data as well as World Health Organization diagnostic criteria.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the May 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we explore prognostication in MPNs, including three newer scoring systems and how genetics research is being incorporated into risk stratification. We also highlight an overview of investigational drugs in the MPN pipeline, as well as new research on the impact of anti-interferon-α antibodies on MPNs and the role of cytomegalovirus in the relapse of myeloproliferative disorders.

If you haven’t done so yet, check out our newest roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case Based Discussion.” Three expert colleagues and I provide an overview of the current state of MPN treatment and management through three in-depth patient cases. You’ll get a front-row seat to insightful discussion and input on myelofibrosis, polycythemia vera (PV), and essential thrombocythemia (ET) from different perspectives within the health care team.

And don’t miss our new “fast facts” guides. These helpful and informative PDFs provide easy access to incidence and mortality data and World Health Organization diagnostic criteria for myelofibrosis, PV, and ET.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the April 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we’re excited to share with you our new roundtable panel discussion, “Management of Myeloproliferative Neoplasms: A Case-Based Discussion.” I am joined by three expert colleagues as we highlight the current state of MPN treatment and management. We take you through three distinct cases covering myelofibrosis (MF), polycythemia vera (PV), and essential thrombocythemia (ET), with discussion and input from different perspectives within the health care team—the oncologist, the pharmacist, and the nurse practitioner.

As a companion to the panel discussion video, we’ve created “fast facts” guides detailing the incidence and mortality and the World Health Organization diagnostic criteria for MF, PV, and ET. We hope you find them to be a helpful and informative reference in your practice.

And we’re not done yet! In this month’s newsletter, we explore data from trials studying potential MPN treatments involving ruxolitinib, metformin, stem cell transplant, and pacritinib. We also highlight recently published journal articles exploring the emotional and financial impacts of myelofibrosis, the profile of Belgian patients with PV, and the role of Sipa1 deficiency in MPNs.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the March 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. This month, we explore the expanded approval for a JAK2 peripheral blood assay, the safety and efficacy of low-dose hypomethylators in low-risk myelodysplastic syndrome and MPNs, and the use of idasanutlin in refractory polycythemia vera (PV). We also highlight recently published treatment strategies for essential thrombocythemia and PV, research focused on how the presence of specific genetic mutations in patients with post-MPN acute myeloid leukemia may play a role in response to therapy, and the role of the IL28B genotype in MPNs.

I’m also excited to share that we’ve been hard at work on a special case-based video roundtable discussion during which three experts in the field and I will highlight the current state of MPN treatment and management. Stay tuned for this valuable resource in an upcoming newsletter.

If you haven’t done so yet, check out last year’s video roundtable panel discussion, “Perspectives on the Collaborative Management of Myeloproliferative Neoplasms” as a refresher.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

I hope you find this to be a useful and enduring resource in your practice!

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear colleague,

Welcome to the first 2018 edition of our Updates on Myeloproliferative Neoplasms (MPNs) newsletter. As in past editions, each monthly installment will provide articles and news items highlighting the latest in research and treatment paradigms for MPNs. A special upcoming edition will feature a case-based video roundtable discussion during which three experts in the field and I will highlight the current state of MPN treatment and management.

In this January 2018 edition, we explore the latest data coming out of the 2017 American Society of Hematology Annual Meeting, including a Revised DIPSS-Plus scoring system, updated findings from the RESPONSE trial, and cutting-edge research on targeted therapies for MPNs. We also take a look at a recent study showing increased risk for thrombotic events among patients with MPNs, and we learn how the JAK2 inhibitor fedratinib is making a comeback.

I also encourage you to check out last year’s video roundtable panel discussion, “Perspectives on the Collaborative Management of Myeloproliferative Neoplasms” as a refresher.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

I hope you find this to be a useful and enduring resource in your practice!

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the August 2017 edition of our newsletter, Updates on Myeloproliferative Neoplasms. This final edition provides articles on such topics as the risk of age-related macular degeneration in patients with myeloproliferative neoplasms; a new test for detection of hematologic cancer; and a case report on the progression of primary myelofibrosis to polycythemia vera.

For this final edition, I would urge you, if you have not previously done so, to watch the entire MPN expert video roundtable I moderated.  

Please share this newsletter with your colleagues and don’t hesitate to get in touch with me with your comments or suggestions through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com.

Please take a look at the links I’ve gathered for you here. I hope you’ve found this series of newsletters to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the July 2017 edition of our newsletter, Updates on Myeloproliferative Neoplasms. This edition provides articles on such topics as evaluation for CML in the setting of unexplained leukocytosis and thrombocytosis in MPNs, risks and benefits of antithrombotic therapy in essential thrombocythemia, and administration of direct oral anticoagulants in patients with myeloproliferative neoplasms.    

This month I'd like to highlight Chapter 2 of the expert video roundtable I moderated, as it discusses the most common BCR/ABL-negative MPNs.

Please share this newsletter with your colleagues and don’t hesitate to get in touch with me with your comments or suggestions through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the June 2017 edition of our newsletter, Updates on Myeloproliferative Neoplasms. In this edition, I'd like to ask you to watch Chapter 7 of the roundtable discussion my colleagues and I recorded, as it focuses on the importance of clinical trials in the advancement of treatments for MPNs.

I’ve also chosen to highlight articles on such topics as the effect of initial molecular profile on response to recombinant interferon-α (rIFNα) treatment in early myelofibrosis, and the impact of treatments and blood counts on survival and the risk for vascular events during the course of polycythemia vera.   

Please share this newsletter with your colleagues, and don’t hesitate to get in touch with me with your comments or suggestions through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the May 2017 edition of our newsletter, Updates on Myeloproliferative Neoplasms. This edition provides articles on such topics as the recent approval of a JAK2 RGQ PCR kit to evaluate suspected polycythemia vera, the management of venous thromboembolism in myeloproliferative neoplasms, and insight into how downregulation of GATA1 drives impaired hematopoiesis in primary myelofibrosis.

This month I'd like to highlight Chapter 4 of the expert video roundtable I moderated, as it discusses the importance of monitoring for polypharmacy and drug interactions as a means to enhance patient medication adherence.

Please share this newsletter with your colleagues and don’t hesitate to get in touch with me with your comments or suggestions through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the April 2017 edition of our newsletter, Updates on Myeloproliferative Neoplasms. This month I'd like to highlight one of the most important parts of our roundtable discussion on MPNs: an interview with Tina, a very special patient I got to know well during her first three years of treatment. Tina graciously agreed to share her story from diagnosis up through her current management phase, shedding light on how she’s worked with her treatment team to get the best results possible. 

This edition also provides articles on such topics as the prevalence of anxiety and distress among patients with BCR-ABL-negative myeloproliferative neoplasms, genetic profiling as the basis of a groundbreaking myelofibrosis study, and the prognostic impact of bone marrow fibrosis in polycythemia vera. 

Please share this newsletter with your colleagues, and don’t hesitate to get in touch with me through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com, at any time.

Until next time, watch the video of Tina’s story and take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C

Instructor, Medicine-Hematology

University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the February 2017 edition of our newsletter, Updates on Myeloproliferative Neoplasms. This month I'd like to highlight Chapter 6 of the expert video roundtable I moderated, as it discusses current treatment approaches for MPNs.

You’ll also find links to articles on such topics as the significant effects of high symptom burden in patients with myeloproliferative disorders; how genetic profiling can guide stem cell transplantation for patients with myelodysplastic syndromes; and the significance of the differences in hematologic and clinical features between essential thrombocythemia cases with JAK2- or CALR-mutations.

Please share this newsletter with your colleagues, and don’t hesitate to get in touch with me with your comments or suggestions through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

 Lindsey Lyle, MS, PA-C
Instructor, Medicine-Hematology
University of Colorado, Anschutz Medical Campus

Dear Colleague,

Welcome to the January 2017 edition of our newsletter, Updates on Myeloproliferative Neoplasms. This edition provides articles on such topics as improved 5-year survival with early use of ruxolitinib; the potential prognostic power of elevated circulating nucleosomes, and the risk of venous thromboembolism in pregnant women with essential thrombocythemia.

This month I'd like to highlight Chapter 3 of the expert video roundtable I moderated, as it emphasizes the value of obtaining bone marrow fibrosis grades to assist in determining appropriate treatment approaches in patients with primary myelofibrosis.

Please share this newsletter with your colleagues and don’t hesitate to get in touch with me with your comments or suggestions through the editors of The Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C
Instructor, Medicine-Hematology
University of Colorado, Anschutz Medical Campus 

Dear Colleague,

Welcome to the November edition of our newsletter, Updates on Myeloproliferative Neoplasms. This edition provides articles on topics such as the promising results of lenalidomide in patients with myelofibrosis with myeloid metaplasia; successful pregnancies in women with myeloproliferative neoplasms; and findings from a landmark survey on the significant impact of myeloproliferative neoplasms on the overall health and productivity of patients.

This month I’d like to highlight Chapter 5 of the expert video roundtable, as it provides some newer clinical pearls you may not have heard about yet. The video also emphasizes the value of a collaborative team approach when managing patients with cancer.

Please share this newsletter with your colleagues and don’t hesitate to get in touch with me with your comments or suggestions through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C
Instructor, Medicine-Hematology
University of Colorado, Anschutz Medical Campus 

Dear Colleague,

Welcome to the October edition of MPN Updates! In this issue, we provide highlights that emanated from Perspectives on the Collaborative Management of Myeloproliferative Neoplasms, a recent roundtable discussion held in Houston, Texas. Panelists discussed current topics such as the updated 2016 WHO classification of myeloproliferative neoplasms and therapies available for managing complications related to the disease processes. You can view the full video here.

This edition also provides articles on such topics as the utilization of ruxolitinib to control hematocrit levels in polycythemia vera, chromothripsis as a recurrent genomic abnormality in patients with high-risk myelodysplastic syndromes, and bone mineral density and microarchitecture in patients with essential thrombocythemia and polycythemia vera. In our next edition, we plan to provide you with findings from the 7th International Conference on Myeloproliferative Neoplasms being held in Estoril, Portugal.

Please share this newsletter with your colleagues and don’t hesitate to get in touch with me with your comments or suggestions through the editors of the Journal of the Advanced Practitioner in Oncology, or JADPRO, at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this newsletter to be a useful resource in your practice.

Lindsey Lyle, MS, PA-C
Instructor, Medicine-Hematology
University of Colorado, Anschutz Medical Campus

Dear Colleagues,

It is estimated that slightly more than 300,000 Americans have been diagnosed with myeloproliferative neoplasms (MPNs). The three classic forms of BCR-ABL negative MPNs include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (MF), with PV being the most prevalent. Although MPNs can strike anyone at any age, most patients are afflicted in the sixth decade of life or later.

Although outside of allogeneic stem cell transplant, there is no cure for MPNs, there are medical therapies that can inhibit promiscuous signaling pathways caused by genetic mutations, reduce risk of complications, and improve symptom burden. In addition, clinical studies are underway to explore additional therapies.

Here, the Journal of the Advanced Practitioner in Oncology (JADPRO) presents Myeloproliferative Neoplasms (MPN) Updates, a monthly educational newsletter and enduring resource for advanced practitioners. As the editor of the program, I will share articles and news items containing the latest in treatment and management strategies. In the near future, we’ll take a look at the most relevant and potentially practice-changing results to come out of the 2016 ASH® Meeting on Hematologic Malignancies. In addition, in our next edition we’ll be presenting a video roundtable discussion with several of my distinguished colleagues on current issues in MPN.

Please feel free to share this newsletter with your colleagues, and don’t hesitate to get in touch with me with comments or suggestions through the JADPRO editors at editor@advancedpractitioner.com at any time.

Until next time, take a look at the links I’ve gathered for you here. I hope you find this to be a useful resource in your practice!

Lindsey Lyle, MS, PA-C
Instructor, Medicine-Hematology
University of Colorado, Anschutz Medical Campus