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MPN Workshop of the Carolinas 2025 | The current approach to risk stratification and treatment selection in patients with ET
In this video, Lucia Masarova, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, comments on the current approach to risk stratification and treatment selection in patients with essential thrombocythemia (ET), noting that current guidelines focus on preventing thrombosis in high-risk patients but do not address symptoms of the disease. This interview took place at the 2nd Annual MPN Workshop of the Carolinas, held in Charlotte, NC.
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Transcript
That’s a very important topic and we’ve heard some of this conference already, starting with a plenary session from Dr Mesa about the symptoms. So we have a currently established course for treating versus not treating patients with ET, where the standard high-risk patient would be those older or those that had a previous thrombosis. But those are to prevent another thrombosis, you don’t impact the long-term disease behavior...
That’s a very important topic and we’ve heard some of this conference already, starting with a plenary session from Dr Mesa about the symptoms. So we have a currently established course for treating versus not treating patients with ET, where the standard high-risk patient would be those older or those that had a previous thrombosis. But those are to prevent another thrombosis, you don’t impact the long-term disease behavior. We kind of abandon and look away from symptomatic patients, from patients that will be progressing other ways.
Then there are criteria for starting therapy that would be beyond aspirin in patients with extreme platelets, in patients that would have otherwise other concerns or symptoms, but I think that’s not that much addressed that there could be extremely symptomatic young individuals that would have what look like almost normal count but have extremely poor quality of life.
So we use a standard stratification where we basically treat everybody with aspirin except for people with extreme thrombocytosis or specific criteria and then we use cytoreduction for high-risk patients, either the older ones or those that had a thrombosis. And then in the specific circumstances, people will have more symptoms or they would have extreme thrombocytosis or otherwise uncontrolled, rarely splenomegaly, but we could see whether some patients would fit this criteria.
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