Significant heterogeneity in management of calreticulin-mutated essential thrombocythemia and its progression to myelofibrosis: results of a national survey

Leuk Lymphoma. 2023 Dec;64(12):2018-2025. doi: 10.1080/10428194.2023.2242992. Epub 2023 Aug 13.

Abstract

Despite the recent publication of calreticulin (CALR)-mutated essential thrombocythemia (ET) management guidelines by the European Leukemia Net (ELN), there remains a paucity of data regarding the optimal way to manage this condition. To determine practice around Australia, we constructed a survey asking investigation and treatment questions in a hypothetical case of a young woman with CALR-mutated ET and subsequent progression to myelofibrosis. 51 of 88 hematologists replied. The responses demonstrated significant heterogeneity in specific issues such as the use of aspirin, when to initiate cytoreduction, the preferred type of cytoreduction, and platelet targets. These observations support the ELN acknowledgment that a strong evidence base for many management recommendations is lacking in this disease, and that substantial further research is needed.

Keywords: Calreticulin; myeloproliferative neoplasm; national survey.

MeSH terms

  • Blood Platelets
  • Calreticulin / genetics
  • Female
  • Humans
  • Janus Kinase 2 / genetics
  • Leukemia*
  • Mutation
  • Primary Myelofibrosis* / diagnosis
  • Primary Myelofibrosis* / genetics
  • Primary Myelofibrosis* / therapy
  • Thrombocythemia, Essential* / diagnosis
  • Thrombocythemia, Essential* / genetics
  • Thrombocythemia, Essential* / therapy

Substances

  • Calreticulin
  • Janus Kinase 2