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MPN Workshop of the Carolinas 2025 | Risk stratification of patients with MPN-AP/BP
Anand Patel, MD, University of Chicago Medical Center, Chicago, IL, provides insight into the risk stratification of patients with accelerated/blast-phase (AP/BP) myeloproliferative neoplasms (MPNs), highlighting that there are currently no consensus risk stratification criteria for MPN-AP/BP. Although acute myeloid leukemia (AML) risk stratification tools can be used in this patient population, Dr Patel notes that they are only moderately informative. This interview took place at the 2nd Annual MPN Workshop of the Carolinas, held in Charlotte, NC.
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Transcript
It’s a great question. I think the first point I want to highlight is unfortunately, even when you risk stratify patients, outcomes are still fairly poor in this patient population, so median overall survival of less than one year. That being said, we’ve done some work to identify can we use AML-based risk stratification criteria to identify the particularly high-risk subsets of patients...
It’s a great question. I think the first point I want to highlight is unfortunately, even when you risk stratify patients, outcomes are still fairly poor in this patient population, so median overall survival of less than one year. That being said, we’ve done some work to identify can we use AML-based risk stratification criteria to identify the particularly high-risk subsets of patients. And when we use, for example, the ELN 24 AML lower intensity criteria, we do get reasonable stratification. We identify patients that are particularly high-risk, such as those with TP53 mutations. Ultimately, though, I’d say those risk stratification tools are only moderately informative. So to put things in perspective, you can apply something called a C-statistic to the application of risk scores. 0.5 is like a coin flip. One is perfect. And the AML-based risk criteria operates somewhere in the neighborhood of 0.5 to 0.6 in terms of how effective they are. So better than a coin flip, but not by a whole lot.
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Disclosures
Honoraria: Abbvie, Astellas, Amgen, Jazz, Sobi, Syndax; Research funding (inst): Incyte, Servier, Pfizer, Sumitomo.
