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MPN Workshop of the Carolinas 2025 | Identifying patients with accelerated or blast-phase MPNs
Anand Patel, MD, University of Chicago Medical Center, Chicago, IL, outlines the key clinical and biological features that can be used to identify patients with myeloproliferative neoplasms (MPNs) whose disease is in the accelerated or blast phase. He notes that a blast percentage of greater than 10% in the blood or bone marrow indicates progression from chronic-phase MPNs to acute leukemia. Dr Patel also emphasizes the importance of identifying high-risk molecular features that are indicative of disease progression. This interview took place at the 2nd Annual MPN Workshop of the Carolinas, held in Charlotte, NC.
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Transcript
Yeah, so really, you know, the things that we look at when we’re thinking strictly about the definition is blast percentage. So 10 to 19% blasts, whether it be in the blood or in the bone marrow, is associated with accelerated phase disease, and greater than or equal to 20% blast is associated with blast phase disease. I do think it’s important to note that the clinical history, once patients have greater than 10% blasts is fairly similar, no matter kind of what their absolute blast percentage is...
Yeah, so really, you know, the things that we look at when we’re thinking strictly about the definition is blast percentage. So 10 to 19% blasts, whether it be in the blood or in the bone marrow, is associated with accelerated phase disease, and greater than or equal to 20% blast is associated with blast phase disease. I do think it’s important to note that the clinical history, once patients have greater than 10% blasts is fairly similar, no matter kind of what their absolute blast percentage is. So really, in my mind, I really like to think of once someone has more than 10% blasts, they’re behaving like they’re in evolution to acute leukemia, even if they haven’t yet hit that threshold of 20%. Now, when patients have this progression, oftentimes there will be acquisition of high-risk mutations. So we do also reprofile patients molecularly, look for things like TP53, ASXL1, RUNX1, and IDH mutations. So sometimes those molecular features can also be clues into the fact that a patient is starting to have progression from their chronic phase MPN to the accelerated or blast phase of disease.
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Disclosures
Honoraria: Abbvie, Astellas, Amgen, Jazz, Sobi, Syndax; Research funding (inst): Incyte, Servier, Pfizer, Sumitomo.
