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INGRAIN-MF
Incorporating genetics, risk and associated burden into MF management

MODULE 1: The burden of myelofibrosis

Having completed this module, you should now have a better appreciation of:

  • survival and transformation rates in MF
  • diagnostic criteria, including bone marrow biopsy, blood tests and clinical features
  • the symptom burden on patients, whether it is under-recognised, and how it affects quality of life
  • objective monitoring of symptoms

Retest your knowledge below.

Post-module multiple-choice questions

When your answers have been submitted, you will be able to review the correct answers and receive your final score.

Correct answer is highlighted.

Answer: MF has a 5-year survival rate of 39%. This is higher than acute myeloid leukaemia (32%), but lower than myeloma (61%) and chronic lymphocytic leukaemia (89%). Polycythaemia vera and essential thrombocythaemia, other BCR-ABL1-negative MPNs, have 5-year survival rates of 75% and 76%, respectively.1-4

Correct answer is highlighted.

Answer: A real-world study in the UK found that enlarged spleen at diagnosis was documented for 47% of patients with MF (n=200). Breathlessness and weight loss were reported by 9% and 21% of patients, respectively.5

Correct answer is highlighted.

Answer: MF-1 is defined in the 2016 revision to the World Health Organization classification of myeloid neoplasm and acute leukaemia as: loose network of reticulin with many intersections, especially in perivascular areas.6

Correct answer is highlighted.

Answer: The majority of patients believe that they often feel worse than their clinician is aware of.7 Some patients may not be forthcoming about their symptoms, and they may also have developed 'coping mechanisms' for their symptoms, and as such not understand how severe they are.8 Using symptom assessment tools can help to provide an objective measure of symptom burden.9

Correct answer is highlighted.

Answer: The MPN10 symptom assessment takes into account 10 different symptoms, but does not include dizziness or light-headedness.9

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Adverse events should also be reported to Novartis online through the pharmacovigilance intake (PVI) tool at www.novartis.com/report or alternatively email medinfo.uk@novartis.com or call 01276 698370

References
  1. National Cancer Institute. SEER Cancer stat facts: chronic lymphocytic leukemia. Available at: seer.cancer.gov. Accessed April 2025
  2. National Cancer Institute. SEER Cancer stat facts: acute myeloid leukemia. Available at: seer.cancer.gov. Accessed April 2025
  3. National Cancer Institute. SEER Cancer stat facts: myeloma. Available at: seer.cancer.gov. Accessed April 2025
  4. Brunner A M, Hobbs G et al. A population-based analysis of second malignancies among patients with myeloproliferative neoplasms in the SEER database. Leuk Lymphoma 2016;57(5):1197-1200
  5. Mead A, Somervaille T. A retrospective real-world study of the current treatment pathways for myelofibrosis in the UK (the REALISM UK Study). Presented at the 61st American Society of Hematology Meeting, Orlando, Florida, US, 7-10 December 2019; poster 1671
  6. Arber D A, Orazi A et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 2016;127(20):2391-2405
  7. Harrison C N, Koschmieder S et al. The impact of myeloproliferative neoplasms (MPNs) on patient quality of life and productivity: results from the international MPN Landmark survey. Ann Hematol 2017;96(10):1653-1665
  8. Knight E A, Osunsuyi-Fagbemi S, Neely J. Managing patients with myelofibrosis in the era of Janus kinase inhibitors. J Adv Pract Oncol 2015;6(6):532-550
  9. Emanuel R M, Dueck A C et al. Myeloproliferative neoplasm (MPN) symptom assessment form total symptom score: prospective international assessment of an abbreviated symptom burden scoring system among patients with MPNs. J Clin Oncol 2012;30(33):4098-4103