Myeloid & Lymphoid disorders in practice - 2009

Comment: MPNs and clinical trials – from famine to feast?
John Reilly
pp 2-2
Should the health of a specialty be judged on the number of open and/or planned clinical trials, then the field of chronic myeloproliferative neoplasms is clearly on its way to full recovery. The dearth of clinical trials that characterised the 1990s has been replaced by a plethora of novel approaches, although whether this activity will produce long-term benefits for our patients remains to be determined.

How to treat chronic myelomonocytic leukaemia
Mark Drummond
pp 3-5
Chronic myelomonocytic leukaemia (CMML) is a disorder that continues to present a diagnostic, prognostic and therapeutic challenge. Its current status as a myelodysplastic/myeloproliferative (MDS/MPD) overlap syndrome mirrors its mixed clinical presentation as a disorder exhibiting predominantly cytopenias or myeloproliferation and extramedullary disease, or, indeed, a bit of both.

Molecular diagnosis of chronic MPNs
Anna L Pozo, Anthony J Bench and Wendy N Erber
pp 6-9
The four classic chronic myeloproliferative neoplasms (MPNs) – chronic myeloid leukaemia (CML), polycythaemia vera (PV), essential thrombocythaemia (ET) and primary myelofibrosis (PMF) – were first grouped together by Dameshek in 1951. The molecular basis of CML was established following the identification of the Philadelphia chromosome in 1960, and the resulting t(9;22)(q34;q11) BCR-ABL translocation is now the subject of molecularly targeted therapy.

Allogeneic SCT in AML: who should you transplant?
Charles Craddock
pp 10-13
Despite advances in chemotherapy and supportive care, the prospect of long-term survival for many adults with acute myeloid leukaemia (AML) remains poor. While it is now possible to identify a population of adults likely to be cured with standard chemotherapy, it remains the fact that the majority of newly diagnosed patients are destined to die of resistant disease.

A nurse/pharmacist-led service for managing patients with MPNs at a distance
Theresa Peters, Sue Coppin, Vicki Clarke, Sarah A Wexler and Christopher JC Knechtli
pp 14-15
A nurse/pharmacist-led service was set up in 2005 at the Royal United Hospital (RUH) Bath for patients with essential thrombocythaemia (ET), polycythaemia vera or other myeloproliferative neoplasms (MPNs) being treated with hydroxycarbamide. This service was set up by the haematology clinical nurse specialist (CNS), the junior sister in the haematology outpatient clinic and an oncology/haematology pharmacist, with support from consultant haematologist colleagues.