Common MPN Driver Mutations and Their Impact on Survival

Haris Ali, MD, a hematology oncologist at the City of Hope Comprehensive Cancer Center, discusses common myeloproliferative neoplasms (MPN) driver mutations. 

According to Ali, the most common mutations are JAK mutations, with JAK2 being the most common among high-risk patients. However, CALR and FTL mutations were also found to be common.

Ali and investigators studied the effect of driver mutations in a study (NCT02917096) looking at ruxolitinib (Jakafi) as peri-transplant treatment for MPNs. Driver mutations were found to be associated with a slightly higher risk of worse outcomes. However, the study was small and needs to be expanded to more patients.

According to Ali, study results point to 10mg twice a day of ruxolitinib is a good dose for these patients. Plans to expand the study to more patients are ongoing.

0:08 |The most common driver mutations are JAK mutations, others are CALR and FTL mutations. JAK2 is more of a high-risk mutation. Among the driver mutations, it's a slightly higher risk. We did not see any impact of mutations on the study. However, this is actually a small study, we definitely need to expand it to a larger number of patients. We are collaborating with other institutions to look at the impact of mutation in a large population to see if these mutations have any impact on the transplant outcomes in patients with myelofibrosis.

0:49 |This is a study with 18 patients where we saw a very positive response. There is a signal that 10 milligrams twice a day is a good dose in these patients. We are planning to expand it into more randomized trials in the future where we can definitely show the impact and can improve the outcomes of a transplant in patients with myelofibrosis.