Disease Management Strategies Among Patients With MPNs

Patients with myeloproliferative neoplasms (MPNs) have high disease burden, and management of their disease, which includes myelofibrosis (MF), polycythemia vera (PV), and essential thrombocythemia, can vary widely to include watchful waiting, phlebotomy, or drug therapy.

Research presented at the European Hematology Association annual meeting revealed not only a lack of urgency to treat MF in patients, but that more than 40% of physicians have never prescribed ruxolitinib even when it is available to treat MF in their country.

The researchers conducted a multicountry, cross-sectional survey in China, Turkey, Russia, Taiwan, South Korea, and Saudi Arabia to understand disease management practices as reported in an expansion of the MPN LANDMARK survey.

The survey included responses from 506 patients and 240 physicians. Up to a quarter (18% to 24%) of physicians had chosen to observe patients at diagnosis instead of recommending a treatment. Across all 3 MPNs, hydroxyurea was the most commonly prescribed treatment (78% to 93%).

For patients with MF, ruxolitinib (59%) was the most commonly ever prescribed treatment, followed by interferon (44%).

For PV, phlebotomy was ever prescribed by 75%, and although 74% of these physicians indicated it was at least somewhat burdensome to patients, 72% of physicians continued to prescribe phlebotomy to their patients with PV. While 64% of the patients with PV receiving phlebotomy at least once a month said that it at least somewhat affecting their quality of life, the reason why the majority (65%) stopped phlebotomy was because of the physician decided it was no longer necessary.

Overall, patient preference led to therapy changes in just 22% to 26% of patients, and the most frequent reasons why patients across MPNs changed therapy were disease progression (83% to 85%), lack of efficacy (80% to 84%), and adverse effects (73% to 78%).

Patients and physicians had differing views of how well disease was being managed. While two-thirds of patients strongly believed their physicians were concerned about helping them, listened to concerns, and addressed questions, only one-third of physicians thought that was how their patients felt.

“Interestingly, perception of disease management appeared to be better among [patients] than physicians,” the authors concluded.

Reference

Chang CS, Xiao Z, Morozova EV, et al. Treatment and disease management practices in patients with MPNs in 6 countries: an expansion of the MPN LANDMARK survey. Presented at: EHA25 2020; June 11-21, 2020; Abstract EP1123.