Recent advances in the diagnosis and management of primary myelofibrosis
The Korean Journal of Internal Medicine
;
: 679-690, 2018.
Article
in English
| WPRIM
| ID: wpr-716080
ABSTRACT
Primary myelofibrosis (PMF) is a myeloproliferative neoplasm (MPN) in which dysregulation of the Janus kinase/signal transducers and activators of transcription (JAK/STAT) signaling pathways is the major pathogenic mechanism. Most patients with PMF carry a driver mutation in the JAK2, MPL (myeloproliferative leukemia), or CALR (calreticulin) genes. Mutations in epigenetic regulators and RNA splicing genes may also occur, and play critical roles in PMF disease progression. Based on revised World Health Organization diagnostic criteria for MPNs, both screening for driver mutations and bone marrow biopsy are required for a specific diagnosis. Clinical trials of JAK2 inhibitors for PMF have revealed significant efficacy for improving splenomegaly and constitutional symptoms. However, the currently available drug therapies for PMF do not improve survival. Although allogeneic stem cell transplantation is potentially curative, it is associated with substantial treatment-related morbidity and mortality. PMF is a heterogeneous disorder and decisions regarding treatments are often complicated, necessitating the use of prognostic models to determine the management of treatments for individual patients. This review focuses on the clinical aspects and outcomes of a cohort of Japanese patients with PMF, including discussion of recent advances in the management of PMF.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Splenomegaly
/
Transducers
/
World Health Organization
/
Biopsy
/
Bone Marrow
/
RNA Splicing
/
Mass Screening
/
Cohort Studies
/
Mortality
/
Disease Progression
Type of study:
Diagnostic study
/
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2018
Type:
Article
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