EHA 2024 | How to approach the treatment of younger patients with MPN

How do I approach younger patients with MPNs? So, I think this is a phenomenal question, and it definitely remains a challenge within the field. So younger patients with MPNs are obviously patients that are going to live with these diseases for a much longer period of time. And so I think, within the context of MPN care and patient care, this is really a significant unmet need because younger patients are potentially going to be exposed to therapies and the side effects and the adverse effects of therapies for a much longer period of time in comparison to patients who perhaps are older. And so my general approach to patients with MPNs who are younger is to first sit down and look at their age, their risk factors for disease, assess different things like their quality of life and determine number one if treatment is necessary. So not all patients require immediate intervention. But really when we have younger patients is to sit down and consider all the risk factors and other life-specific factors, such as family planning and whether people are interested in having a family or not. We consider all those factors and decide if patients need to be treated or what the appropriate timing of treatment is, and then the decision and, you know, the approach to younger patients is to decide, what agent we’re going to use for these patients, which again, can be challenging, especially within the context of the younger patient. 

I think, when we look at specific MPNs such as myelofibrosis, when I’m thinking about younger patients the question that always comes to mind within the context of treatment is whether or not patients qualify or should be considered for stem cell transplant. So within the context of MPN care, the only curative therapy we currently have is stem cell transplant for patients, and so this is oftentimes an option, more so for patients who are younger with fewer comorbidities. And so I think, one of the things I will always try and do in clinic and when I’m interacting and talking to patients, is really have that conversation early and upfront to determine if we need to get people sent over for transplant evaluation. So that’s something that I really think about, especially in the younger patient population.