Of interest to anyone using/considering Peg/INF - MPN Voice

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Of interest to anyone using/considering Peg/INF



Very detailed up to date summary of INFs albeit mostly beyond my pay grade. I thought encouraging for those of us on INF/Peg but there still appear to be the two Camps of Hems - pro HU first line and pro INF first line.

For those of us who are TET2 and JAK2 +, this article is a must read. Appears the TET2 mutation implies a poorer prognosis and greater resistance to INF. something I will be discussing with my Hem next visit.

However I thought the most interesting part of the article was the impact of inflammation on the effectiveness of INF/Peg. The article cites smoking as an inhibitor of INFs.

This begs the question, does inflammatory food also inhibit the effectiveness of INFs. I know there are several ongoing MPN targeted anti inflammatory diet trials.

Maz - if you are reading this, would it please be possible to ask the Prof whether there is a chance that an anti inflammatory diet could enhance the effectiveness of INFs?

I appreciate that there is probably no hard clinical evidence but if there is a chance, I can’t see the downside of being pre-emptive. After all, an anti-inflammatory diet pretty much equates to a healthy diet anyway, reduce refined sugars, carbs, processed food etc.

Thanks Paul

6 Replies

Hi Paul,

Thanks for the link to the article. It is very interesting and positive in its outlook.


Thank you Paul, very interesting to me as I'm Jak2 pos and TET2. Best wishes, Frances.

Maz if you are reading this I would also like to know if an anti inflammatory diet is advisable as I have now seen this in various posts.

Thanks for the information Paul


This part is encouraging - the Danish study results yet to be announced?

The rationales for these combinations have been thoroughly described and discussed in most recent reviews [51, 124, 125, 126, 127, 128], and preliminary results from the first Danish studies are indeed very promising [177, 178]. In patients in the accelerated phase towards leukemic transformation and in patients having transformed to acute myeloid leukemia, the prognosis is dismal [185]. However, even in these stages, IFN-alpha2 may be an option [186] with the potential as monotherapy to revert imminent or overt leukemic transformation [186]. Importantly, recent studies have shown that monotherapy with the DNA-hypomethylator azacytidine [187] may be efficacious in these patients, and combination therapy with a DNA-hypomethylator and ruxolitinib may be even more efficacious [188]. Based upon the above studies of monotherapy with IFN-alpha2 and combination therapy with DNA-hypomethylating agents and ruxolitinib in patients towards or with leukemic transformation, it is intriguing to consider if “triple therapy” (IFN-alpha2 + DNA-hypomethylator + ruxolitinib) may be even more efficacious

Thanks Paul, my brother in law has mutated from ET, CALR to Acute Myloid Leukaemia, so very much of interest to me. Many thanks.


Hi Paul, Prof Harrison has replied: the UK guidelines reflect UK practice and suggest that either HU or IFN should be offered and an individual decision made.

The data on TET2 is based on a small number of patients but definitely makes interesting reading..

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