Myeloid & Lymphoid disorders in practice - 2010

Comment: Second-generation TKIs – awaiting a NICE decision!
John Reilly
pp 2-2
The occasion was the New Horizons in Haematology meeting in Lisbon. The guest speaker had just concluded an update of the modern management of chronic myeloid leukaemia (CML) and, in response to a question from the floor, indicated that it was unlikely that second-generation tyrosine kinase inhibitors (TKIs) would be routinely funded in the UK.

Transitions within the MPNs: diagnosis and management
Thomas Stauffer Larsen and Hans Carl Hasselbalch
pp 3-15
In 1951, William Dameshek introduced the concept of the chronic myeloproliferative disorders as a group of closely related disease entities. In early 2005, a breakthrough in our understanding of the biology of these diseases was made by the discovery of the JAK2 V617F mutation. Since then, the classical concept of the Philadelphia chromosome (Ph)-negative chronic myeloproliferative neoplasms (MPNs) as separate disease entities – essential thrombocythaemia (ET), polycythaemia vera (PV) and primary myelofibrosis (PMF) – has been increasingly challenged, being replaced by the hypothesis of a biological continuum in accordance with, and favouring the ‘proof’ of, Dameshek’s concept.

Managing thrombocytosis – a review of the BCSH guideline
Mary Frances McMullin
pp 7-8
UK medical experts have reviewed the evidence on thrombocytosis in adults and children and published a guideline for its diagnosis and management. This article summarises and discusses the main points of the British Committee for Standards in Haematology (BCSH) guideline.

Lessons from the PT-1 trials: the PT-1 story
Christina A Ortmann, Philip A Beer and Anthony R Green
pp 9-11
Primary Thrombocythaemia 1 (PT-1) is a suite of three prospective clinical trials established to determine best therapy for patients with essential thrombocythaemia (ET). Initiated in 1997, over 1,100 patients from centres in the UK, Australia, New Zealand and France have been enrolled to date, including both newly diagnosed and previously treated individuals. Using factors shown to predict the occurrence of thrombotic complications, patients are stratified as high-, intermediate- or low-risk.

How to treat myelodysplastic/myeloproliferative neoplasms
Fiona Nicholson, Nicholas Heaney and Mark Drummond
pp 12-15
Myelodysplastic/myeloproliferative neoplasms (MDS/MPNs) are a group of clonal myeloid disorders characterised by the presence of both dysplastic and proliferative features. The 2008 WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues places four entities in this group: chronic myelomonocytic leukaemia (CMML), juvenile myelomonocytic leukaemia (JMML), atypical chronic myeloid leukaemia (aCML) and MDS/MPN unclassifiable.