Roundtable Roundup: Challenges of Treating Myelofibrosis
In separate live virtual events, James K. McCloskey II, MD, and Bart L. Scott, MD, polled participants on disease symptoms and bridging therapy options for a patient with primary myelofibrosis (PMF).
CASE SUMMARY
A man aged 62 years presented to his primary care physician (PCP) with symptoms of fatigue, night sweats, and increased bruising .
Medical history: type 2 diabetes, hypercholesterolemia, and hypertension
The PCP noticed lower hemoglobin concentration (11.0-9.5 g/dL) and platelet count (350,000-195,000/μL) from a previous annual physical examination.
Two months post PCP visit, a hematologic oncologist saw him.
Examination findings: spleen 5 cm below left costal margin, fatigue and night sweats worsening, bone pain
Hemoglobin: 9.1 g/dL
Platelet count: 135,000/μL
Bone marrow fibrosis of grade 2/3, with less than 5% bone marrow blasts
Molecular analysis showed a JAK2 V617F mutation with normal karyotype and no additional mutations .
He had a history of squamous cell carcinoma of the skin .
ECOG performance status: 2
Blood: 1% blasts by manual count/flow cytometry
Diagnosis: PMF
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