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NCCN Guidelines: Categories and Recommendations in Myelofibrosis

Opinion
Video

Aaron Gerds, MD, MS, reviews the National Comprehensive Cancer Network (NCCN) guideline categories, including evidence, and recommendations for symptomatic high-risk myelofibrosis. He discusses considerations for selecting JAK inhibitors and the threshold for switching treatments based on responses.

This is a video synopsis/summary of a Guidelines involving Aaron Gerds, MD, MS.

Gerds discusses the categorization of recommendations in the NCCN guidelines, providing insights into how they are determined. Categories range from 1 (high-quality data and strong consensus) to 3 (lack of consensus), guiding clinicians on treatment decisions. Gerds emphasizes the importance of evidence blocks for a separate evaluation of evidence quality. Moving on to the NCCN guidelines for symptomatic higher-risk myelofibrosis (MF), he outlines considerations for JAK inhibitors such as ruxolitinib, pacritinib, momelotinib, and fedratinib. Specific patient factors, such as severe thrombocytopenia or intact marrow, influence the selection. The guidelines address challenges in second-line settings, encouraging a switch to another JAK inhibitor if the current 1 is ineffective. Gerds introduces the RR6 prognostic model (response to ruxolitinib after 6 months), emphasizing triggers such as spleen volume reduction and nontransfusion dependence to guide treatment continuation with ruxolitinib. The discussion provides valuable insights into the NCCN guidelines, offering clinicians a comprehensive approach to tailor MF treatment based on patient-specific factors and responses.

Video synopsis is AI-generated and reviewed by AJMC® editorial staff.

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