Report on Current MPN research, and lots of other stuff

[EPguy]

This report has a nice graphic on current MPN research. There have been posts on this before too but this one is particularly colorful.

Some we know are here, the new Jak2 inhibitors, Momelotinib, etc . (the blue Kinase) Bomedemstat is a LSD1 inhibitor (dark blue)

One that is missing is Rusfertide ( hepcidin mimetic) So maybe this list is not complete.

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Another very good summary of mutations vs risk in in here. Indication is TET2, DNMT3A are not large factors, as other posts have discussed. CHIP are mutations that are of "indeterminate potential":

"Mutations of ASXL1, IDH1/2, EHZ2 or SRSF2 are detected in every third PMF patient and are associated with shorter OS and leukemia-free survival [38]. With regards to fibrotic progression, no association with the CHIP-associated mutations TET2, ASXL1, DNMT3A was found; in contrast, mutations of SRSF2, U2AF1, SF3B1, IDH1/2, and EZH2 that are rarely found in CHIP showed a strong correlation with fibrotic progression [39]."

ncbi.nlm.nih.gov/pmc/articl...

[Mostew]

Thank you . Lovely and clear and colourful . Makes it easier to understand

[Aldebaran25]

Good post, very informative, thanks EPguy! I have not had a genetic panel done, may choose to do one at some stage (willing to pay for it if necessary), but at times I wonder whether I really want to know whether I may be at higher risk. I feel that interpretation is still at an early stage and I don’t want to make myself worry unnecessarily. I know, you could call it an ostrich attitude but there must be so many different genes at play, some probably still not known to be associated with MPN outcomes that prediction seems rather uncertain to me.

[EPguy in reply to Aldebaran25]

I agree about the early stage. One possible advantage to NGS is for reference in future therapies. Some of the future immune therapies will individually customized and rely on genetic details, possibly past and present. But MPN does not have such yet.

Are you still on PEG now?

[Aldebaran25 in reply to EPguy]

I have not started PEG yet, expecting to do so in a couple of weeks. Still on HU and doing quite well, tbh, but PEG seems a wiser choice in the long term. Problem is I also suffer from cutaneous sarcoidosis, so impact of PEG on that will be interesting 🤞

[Meatloaf9]

Thank you for posting this interesting article. Only just skimmed over the content, will read it in depth later. Not a lot of studies that address progression of mpn's as thoroughly as this one, at least as far as I have found. I think progression is one common interest we all have. I plan to print and take this to my local hematologist next week. I think I remember discussing non driver mutations with my mpn specialist (I have dnmt3a), a few were high risk, but my takeaway was when you get about 4 or more it gets real serious, don't quote me on that, my memory is not what it once was. Thanks again for posting. Best to you.

[EPguy in reply to Meatloaf9]

Agree this report is packed. There is a study I've seen, and likely posted somewhere, that does discuss the quantity implications on non-drivers with a graphic. But it does seem which ones also matters.