Guidelines for the management of myeloproliferative neoplasms

Korean J Intern Med. 2015 Nov;30(6):771-88. doi: 10.3904/kjim.2015.30.6.771. Epub 2015 Oct 30.

Abstract

Polycythemia vera, essential thrombocythemia, and primary myelofibrosis are collectively known as 'Philadelphia-negative classical myeloproliferative neoplasms (MPNs).' The discovery of new genetic aberrations such as Janus kinase 2 (JAK2) have enhanced our understanding of the pathophysiology of MPNs. Currently, the JAK2 mutation is not only a standard criterion for diagnosis but is also a new target for drug development. The JAK1/2 inhibitor, ruxolitinib, was the first JAK inhibitor approved for patients with intermediate- to high-risk myelofibrosis and its effects in improving symptoms and survival benefits were demonstrated by randomized controlled trials. In 2011, the Korean Society of Hematology MPN Working Party devised diagnostic and therapeutic guidelines for Korean MPN patients. Subsequently, other genetic mutations have been discovered and many kinds of new drugs are now under clinical investigation. In view of recent developments, we have revised the guidelines for the diagnosis and management of MPN based on published evidence and the experiences of the expert panel. Here we describe the epidemiology, new genetic mutations, and novel therapeutic options as well as diagnostic criteria and standard treatment strategies for MPN patients in Korea.

Keywords: Polycythemia vera; Practice guideline; Primary myelofibrosis; Thrombocythemia, essential.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Asian People / genetics
  • Humans
  • Janus Kinase 2 / antagonists & inhibitors*
  • Janus Kinase 2 / genetics
  • Janus Kinase 2 / metabolism
  • Molecular Targeted Therapy
  • Mutation
  • Myeloproliferative Disorders / diagnosis
  • Myeloproliferative Disorders / drug therapy
  • Myeloproliferative Disorders / enzymology
  • Myeloproliferative Disorders / ethnology
  • Myeloproliferative Disorders / genetics
  • Protein Kinase Inhibitors / therapeutic use*
  • Republic of Korea / epidemiology
  • Risk Factors
  • Signal Transduction / drug effects
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • JAK2 protein, human
  • Janus Kinase 2