Professor Hasselbach said. "To prevent progression of MPN, early and aggressive treatment with interferons that act directly on bone marrow cells is essential to achieve a microscopic residual disease (MRD) status."
« We studied the feasibility of interferon discontinuation in 469 patients with myeloproliferative neoplasms and found that the majority of patients who maintained a hematologic response on interferon treatment for more than two years and had less than 10 percent JAK2 mutant cells did not relapse for more than 10 years after interferon discontinuation," Professor Kiladjian said.
thank you!!!! This is a topic dear to my heart. Appreciate good news about interferons. It’s the only drug therapy that works for me and supports quality of life.
"As molecular response, which is the reduction of JAK2 mutations, is proving to be a surrogate marker for disease progression and prolonged survival, the goal of MPN treatment is expected to shift to achieving molecular response" We've seen a similar relation for Rux on progression so the idea of MR benefits may be quite broad.
--
There seems to be a 2nd message in there near the end from Professor Hasselbach. It's not as clearly worded but as I understand it:
Besremi can be used intermittently in pts who achieve stable CHR, and with 3 years of CHR it can be discontinued. If so it is a second path to discon the IFN.
This suggests min dose for CHR and no more.
Look fwd to a publication of the study, should allow a deeper dive.
--
For another take on it, an earlier report including Professor Kiladjian has this plot and text that combines the findings in the new report:
"IFN discontinuation represents a safe strategy in MPN patients who achieved CHR, and particularly in patients with a driver VAF lower than 10% at time of discontinuation."
This cohort required only at least three months of therapy. So there was effectively no minimum time limit. VAF<10% cut relapse by half.
(this cohort had 50% toxicity discon, likely bec of high dosing common in the early part of that study (2000) and use of non-peg IFN in those early days)
Putting these texts all together there might be a set of conditions that increasingly improve relapse odds upon discon,
-stable CHR at any point,
-stable CHR at any point plus <10% VAF,
-stable CHR at three years independent of VAF, and
-Stable CHR+VAF<10% at two years.
Likely behind these exclusively CHR indications is the known association of CHR and MR.
I was in group 2 here but did not hold CHR past 3 months. There should be members here who are in group 4, and maybe could discontinue.
Sorry I didn't go more into that. In the Besremi (Ropeg) study CHR was "complete haematological response (defined as haematocrit <45% with no phlebotomy in the past 3 months, platelet count <400 × 109/L, and leucocyte count <10 × 109/L)"
They used 45 HCT for both men and women. We hear from members who still require regular phlbs on IFN to stay under 45, this would not meet the CHR of this definition.
So one or both of stable CHR and VAF under 10% are important criteria for best long term response to IFN.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Decisions, decisions 
Interferon side effects
Interferon advice please
