Tag Archive for: myeloproliferative neoplasms

Should MPN Patients and Their Families Continue Telemedicine?

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Should MPN Patients and Their Families Continue Telemedicine? from Patient Empowerment Network on Vimeo.

Can myeloproliferative neoplasm (MPN) patients still get value from telemedicine? Dr. Kristen Pettit from Rogel Cancer Center explains some of the pros and cons of telemedicine visits and ways to optimize MPN patient care.

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Transcript:

Dr. Kristen Pettit:

I think telemedicine has been one of the few good things to come out of the COVID era. There are pros and cons, certainly, some pros are that patients can have increased access to their physicians and their medical teams, particularly the MPN specialty centers that might not be right in their backyard. It’s great, it’s a great way to be able to stay in touch with an MPN specialist.

The less travel, less waiting in a waiting room. Those are all great things, the cons, the downsides to keep in mind are that virtually we can’t feel for spleens, so it’s difficult to tell if the spleen is starting to get enlarged. There can also be some logistical challenges getting blood counts drawn and interpreted before a telehealth visit. But with those minor challenges, I think telemedicine is here to stay, and I think it’s an important part of the care for patients with MPNs. 

Remote monitoring is very important for patients with MPNs, really the most important thing, in my opinion, for patients with MPNs being monitored over time is for them to keep an eye on their symptoms over time, watching for any changes in their bodies that they may feel as far as their spleens feeling more enlarged or feeling more full, or losing weight unexpectedly, feeling more fatigued, any of their MPN symptoms getting worse. All of those are easy to monitor at home, virtually, and to report back to your physician over telehealth or at routine visits.

What Is Chronic Neutrophilic Leukemia?

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What Is Chronic Neutrophilic Leukemia? from Patient Empowerment Network on Vimeo.

Chronic neutrophilic leukemia (CNL) is a rare form of myeloproliferative neoplasm (MPN). Dr. Kristen Pettit from Rogel Cancer Center explains mutations involved in CNL and common CNL symptoms.

See More From the MPN TelemEDucation Resource Center

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Transcript:

Dr. Kristen Pettit:

Chronic neutrophilic leukemia or CNL is a pretty rare myeloproliferative neoplasm. So when we think of MPNs, we more commonly think of ET, PV, or myelofibrosis but there are a couple of other rare subsets and CNL is one of those. CNL is often driven by slightly different mutations as opposed to PV, ET, or myelofibrosis. One common genetic mutation to see in CNL is involving a gene called CSF-3R.

The actual symptoms of CNL are often similar to what’s in seen in other MPNs. We often see constitutional symptoms like fatigue, fevers, chills, night sweats, those sorts of things. We often see splenomegaly as well, the blood count profile looks a little different in CNL, what we typically see is relatively high white blood cell counts made up mainly of mature neutrophils in that white blood cell differential.

The treatments of CNL are somewhat similar to other MPNs, but maybe a little bit different depending on the specific genetic mutation that’s identified for the individual patient.

Notable New MPN Treatments

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Notable New MPN Treatments from Patient Empowerment Network on Vimeo

What’s the latest in myeloproliferative neoplasm (MPN) treatments? Dr. Kristen Pettit from Rogel Cancer Center gives updates about treatment developments for myelofibrosis, polycythemia vera (PV), and essential thrombocythemia (ET) care including JAK inhibitors, BCL-2 inhibitors, BCL-XL inhibitors, BET inhibitors, and others.

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Transcript:

Dr. Kristen Pettit:

There are so many new treatments in MPNs that I’m excited about, so one that is investigational that has been moving through the pipeline is momelotonib, which is a newer JAK inhibitor for patients with myelofibrosis. The mechanism of action is slightly different than the other JAK inhibitors, ruxolitinib (Jakafi), baricitinib (Olumiant), and pacritinib that’s improved as well.

The hope with momelotonib is that it will do some of the good things that the other JAK inhibitors do reduce symptoms and reduce spleen size, but also potentially improve anemia for patients who struggle with anemia, which is such a high proportion of our patients with myelofibrosis. I think that’s one exciting thing, another exciting avenue are new potential up-front treatment strategies that are being studied, so there are a number of different clinical trials going on right now, testing the strategy of either standard ruxolitinib or Jakafi by itself compared head-to-head versus a combination of Jakafi plus another medication.

Those other medications that are being tested in trials include the BET inhibitor called parsaclisib, also BCL-2, BCL-XL inhibitor called navitoclax, and a Pi3 Kinase inhibitor called parsaclisib. These upfront head-to-head treatment strategies are going to be very important to keep an eye out for over the next couple of years. The hope is that these combination strategies could deepen responses and potentially prolong responses when a new drug is combined with the JAK inhibitor as the first treatment option for patients with myelofibrosis. In the later line setting, one thing that’s exciting is Imetelstat, which is a telomerase inhibitor.

This is the first study in my myelofibrosis that is trying to specifically prove whether or not it is linked in survival for patients with myelofibrosis. So, I think that’s very exciting and something to keep an eye out for.

In polycythemia vera, one newer treatment option that’s getting a lot of excitement is the Hepcidin mimetic called rusfertide, this medication will hopefully harness the body’s iron metabolism pathway and act as sort of a chemical phlebotomy as opposed to an actual therapeutic phlebotomy in order to control the hemoglobin and hematocrit for patients with PV as well as improve symptoms.

In ET the newer agents that are being investigated include the BET inhibitor parsaclisib, is also being studied for myelofibrosis as well as an LSD-1 inhibitor called bomedemstat. Both of these look exciting so far, as far as their ability to both control platelet count and improve symptoms for patients with ET.

What Is Next Generation Sequencing for MPNs?

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What Is Next Generation Sequencing for MPNs? from Patient Empowerment Network on Vimeo.

Myeloproliferative neoplasm (MPN) care may include the use of next generation sequencing.  Dr. Kristen Pettit from Rogel Cancer Center explains next generation sequencing and how it is used in MPN patient care.

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Transcript:

Dr. Kristen Pettit:

Next generation sequencing or NGS refers to tests done from the blood or the bone marrow that can look for many different genetic mutations at once. So we know that most patients with MPNs will have mutations in either JAK2, CALR, or MPL but many will also have additional genetic mutations.

These additional genetic mutations may be important prognostically as we know is, we know some of these additional genetic mutations can confer either higher or lower risk of the disease progressing over time. So, I think next generation sequencing or NGS panels should be a part of the work up for most patients with MPNs at the time of initial diagnosis, and probably again, at the time that there’s any concern for disease progression in the future.

What Is Precision Medicine for MPNs?

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Myeloproliferative neoplasm (MPN) patients have the option of precision medicine in the treatment toolbox. Dr. Kristen Pettit from Rogel Cancer Center shares insight about some forms of precision medicine, disease-specific factors, and potential future treatments for personalized medicine.

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Transcript:

Dr. Kristen Pettit:

Precision medicine or personalized medicine can take many forms in the MPN field, certainly decisions about whether to consider something like a stem cell transplant or personalized based on disease-specific factors such as the prognostic risk of the individual disease and based on person-specific factors, for example, the patient’s symptoms, their quality of life, their goals, and their other medical issues. Similar personalized factors go into other treatment decisions such as whether or not to start a JAK inhibitor or other treatment as well.

In the future, I think MPN care will continue to see more personalization, perhaps even involving information like specific genetic mutations, for example, there are drugs that are in development that may target on mutant calreticulin, so those might be possibly more specific treatments for folks just with those CALR mutations.

MPN Treatment Tools and Advancements

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MPN Treatment Tools and Advancements from Patient Empowerment Network on Vimeo.

Dr. Kristen Pettit from Rogel Cancer Center shares MPN treatment updates and recent approvals for patient care.

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Transcript:

Dr. Kristen Pettit:

So research in MPNs has really been moving at an extremely fast pace over the last few years, so just over the past few years, we’ve seen advances in nearly every aspect of MPN care, from diagnosis to risk stratification, to MPN treatment, to support of care. We’ve even seen two new drugs, approved for MPN treatment over the past year, the first was ropeginterferon alfa-2b or Besremi approved for polycythemia vera in December 2021. And the most recent was pacritinib (Vonjo) for patients with myelofibrosis with low platelets approved in February of 2022. So there have been lots of exciting improvements very recently, and I think very, many more to come over the next few years.

But there’s still a long ways to go, some unmet needs in the field still include challenges in treating patients with low blood counts, either anemia or thrombocytopenia, low platelets, both of those are still challenging clinical situations. Also, the situation when JAK inhibitors either don’t work well enough for a patient or stop working overtime, that’s a situation that’s very challenging as well. Fortunately, we have a lot of clinical trials and new investigations going on in both of those areas, and patients with low blood counts and patients who have had inadequate or loss of response to JAK inhibitors. So, stay tuned over the next year or two, I think we’ll see major changes in both of those periods.

What Do Biosensors Mean for Myeloproliferative Care?

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Myeloproliferative neoplasm (MPN) patients can benefit from recent advances in medical uses of biosensors. Watch to learn about biosensor medical advances, advantages for MPN care, and future developments from biosensor use.

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Transcript:

Though biosensors may be more well-known for their use in testing for food and water contaminants, they have emerged for a variety of medical uses as well. Biosensors may be used by healthcare providers in patient monitoring, screening for infections, health management, and disease treatment.

For MPN patients, biosensors can aid in several aspects of their care. Biosensors can detect viruses and bacterial threats, track exercise levels and body chemistry remotely, detect harmful chemicals, track disease progression, and share health information between patients, providers, and anyone else whom a patient authorizes. All of these biosensor capabilities provide for more precise, personalized, and optimal care for each patient.

As biosensors evolve even more over time, they will continue to help refine healthcare. MPN patients can expect even more personalized care than are already offered, and quality of life during treatment should also improve since biometrics more accurately gauge factors like disease progression and treatment progress.

Please remember to ask your healthcare team what may be right for you.

What Does Teleoncology Mean for Myeloproliferative Care?

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What Does Teleoncology Mean for Myeloproliferative Care? from Patient Empowerment Network on Vimeo.

 Myeloproliferative neoplasm (MPN) patients can benefit from various aspects of teleoncology. Watch to learn about teleoncology, benefits for MPN patients, and potential future developments with teleoncology.

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Transcript:

Teleoncology carries out clinical oncology remotely and can cover all aspects of oncology care including cancer diagnosis, treatment, and follow-up phases for patients. As with other cancer types, MPN patients can benefit from many aspects of teleoncology.  

Teleoncology is a more targeted part of telemedicine, which is especially beneficial for MPN care. Teleoncology provides more frequent monitoring of symptoms, treatment side effects, physical functions as well as easier patient access to lab tests and protecting patients from extra exposure to viruses and infection risks.

With the evolution of treatments that can now be delivered via convenient methods like wearable patches, the future of teleoncology looks promising. MPN patients will have fewer visits for their treatment and can enjoy a higher quality of life with more frequent remote check-ins with their MPN specialist.

What Is the Role of Next-Generation Sequencing in MPNs

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What Is the Role of Next-Generation Sequencing in MPNs? from Patient Empowerment Network on Vimeo.

 Myeloproliferative neoplasm (MPN) patients can take advantage of a medical advancement called next-generation sequencing. Watch to learn about next-generation sequencing, what it means for MPN patient care, and potential future developments from next-generation sequencing.

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Transcript:

Next-generation sequencing is a DNA analysis process that allows for sequencing of a portion of a patient’s genome. The process allows for processing of multiple DNA sequences in parallel. Next-generation sequencing also can identify hereditary cancer mutation carriers, cancer mutations, and other things.

Next-generation sequencing is another medical advancement that helps improve MPN patient care. By identifying cancer mutations and hereditary cancer mutation carriers, next-generation sequencing helps oncologists to further refine targeted therapies and personalized medicine – leading to optimal patient care.

As more research continues in next-generation sequencing, it’s possible that new genetic mutations will be discovered to further enhance quality of life with patient symptoms and treatment side effects.

Please remember to ask your healthcare team what may be right for you.

What Does Wearable Technology Mean for Myeloproliferative Care?

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What Does Wearable Technology Mean for Myeloproliferative Care? from Patient Empowerment Network on Vimeo.

Myeloproliferative neoplasm (MPN) patients can add wearable technology as another part of their MPN care toolbox. Watch to learn about monitoring that wearable devices may provide, what it means for MPN care, and future developments from wearable technology.

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Transcript:

Wearable technology has expanded and improved at an impressive rate in recent years. With exercise and health tracking technology with devices like Fitbits and Apple Watches, wearable technology includes devices issued from healthcare providers for the monitoring of heart activity, breathing, brain activity, and more.

Advancements in wearable technology offer advantages to myeloproliferative patients in providing more opportunities for remote monitoring and also for delivering treatment via wearable drug delivery systems. And these technologies provide improved care, more frequency of gauging patient health metrics to improve quality of life, and optimal patient health over time.

With technologies advancing at such a rapid rate, there could be even more opportunities to improve care for myeloproliferative patients. Perhaps miniscule blood draws could even be carried out by wearable technology to provide even more convenience for patients while also protecting them from virus and infection risks in clinical settings.

Please remember to ask your healthcare team what may be right for you.

What Does Remote Patient Monitoring Mean for MPN Patients?

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What Does Remote Patient Monitoring Mean for MPN Patients? from Patient Empowerment Network on Vimeo.

Myeloproliferative neoplasm (MPN) patients are a patient group who already used remote patient monitoring before the COVID-19 pandemic. Watch to learn about remote patient monitoring, recent advancements for MPN patient care, and expectations for future developments from remote patient monitoring.

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Should MPN Patients and Their Families Continue Telemedicine?


Transcript:

Remote patient monitoring was already in use before the COVID-19 pandemic hit, and technology improvements were fast-tracked by federal grants from the U.S. government. Telemedicine appointments and monitoring of the heart, lungs, brain, and muscles through remote technologies can be easily carried out for improved remote care.

Though remote patient monitoring of MPN patients was already in practice through periodic monitoring of blood work, advancements have been made in recent months. These improvements allow patients to visit their MPN specialist less frequently as their provider advises. While protecting patients from virus and infection risks, fewer visits save time and travel costs while also allowing optimal patient care in collaboration with their provider.  

As remote patient monitoring technologies continue to increase and improve over time, they will continue to help refine patient care. MPN patients can expect personalized care that becomes even more tailored to their needs, which will result in improved quality of life and less time in care appointments and traveling time for care appointments.

Please remember to ask your healthcare team what may be right for you.

What Do Telegenetic Consultations Mean for MPN Patients?

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What Do Telegenetic Consultations Mean for MPN PAtients? from Patient Empowerment Network on Vimeo.

Myeloproliferative neoplasm (MPN) patients have a telegenetic consultation as another option that has emerged for the telemedicine toolbox. Watch to learn about telegenetic consultations, what they mean for MPN patients, and future developments.

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Should MPN Patients and Their Families Continue Telemedicine?


Transcript:

Telegenetic consultations are those that can be carried out via telemedicine with genetic counselors. With the rise of genetic mutations playing a factor in cancer care and treatment decisions, it’s a natural progression for telegenetic consultations to become another option in the telemedicine tool box that protects patients from exposure to viruses and potential infections and saves them valuable time, energy, and travel costs.

With personalized medicine becoming an integral part of MPN patient care that analyze genetic mutations like JAK2 mutations and MPL mutations, telegenetic consultations make sense as another part of the tools for MPN care. The future of MPN care looks brighter with these virtual care options as part of the equation.

A form of tattoos called e-skins have now emerged as part of remote health monitoring. Used for detecting physical and electrical functions including heart, muscle, and brain activity, e-skins have shown reliability in monitoring tests even under body stress situations like sweating and while consuming spicy foods.

Please remember to ask your healthcare team what may be right for you.

Understanding What ECG Monitoring Tools Mean for MPN

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Myeloproliferative neoplasm (MPN) patients can add ECG monitoring tools as part of their care. Watch to learn about ECG monitoring tools, their value in MPN care, and future developments from ECG monitoring tools.

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What Do Telegenetic Consultations Mean for MPN Patients?

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What Does Wearable Technology Mean for Myeloproliferative Care?


Transcript:

ECG monitoring tools or those that monitor electrocardiography – electrical activity of the heart – are another helpful tool in monitoring patients of all kinds, including cancer patients. Recent technology advancements have brought ECG monitoring beyond wearable vests and into wearable wristbands and e-skin technologies.

Monitoring patient health involves several aspects with heart health being on the monitoring list. With the advancements in ECG monitoring tools, myeloproliferative (MPN) patients can now have heart monitoring with some advantages. Patients can skip the risks of exposure to viruses and potential infections in clinic settings while also saving valuable time, energy, and travel costs.

Wearable ECG monitoring tools are already reliable, and the technologies will only become more precise as they are used more over time. Some patients who have wearable devices linked to their cell phones have the ability to automatically notify their emergency contacts in the event of concerning heart activity. Automated notifications like this are likely to become more common as technology improves.

Please remember to ask your healthcare team what may be right for you.

Engage MPNs Resource Guide

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Health Educator Turned MPN Patient Speaks to Importance of Specialized Care

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Myeloproliferative neoplasm (MPN) patient and health educator Julia Olff helped others navigate the healthcare system before her diagnosis with myelofibrosis and later with ET. Watch as she shares her unique experience and how finding MPN specialists can help patients in receiving optimal care.  

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Transcript:

Julia Olff:

Well, as a health educator and as a former hospital administrator when I was diagnosed with myelofibrosis, I feel like I had a particular reaction to the diagnosis that might be different from others who didn’t work in healthcare. I was both fascinated, which may sound really bizarre, that I was being diagnosed with an illness that I did not feel. Also, an illness I had not heard of, although I knew about some of the treatments that might be proposed because of my work as a health educator. So, I feel like I kind of went into health educator mode and health navigator mode, and that gave me a leg up in terms of knowing very early on, that once my ET transformed to myelofibrosis, I knew that I needed to see an MPN expert. And because I worked on health education because I worked in hospitals, I understood that I want, I needed to see a physician who had a depth of expertise, who had a volume of patients, who had a lot of experience with the drugs that existed. Although, in 2008, there was no approved, drug for myelofibrosis, but I knew I needed to go to the place where there was…

Where I had a better chance of getting the latest treatment, and I was diagnosed by a community oncologist who was lovely and one of the nicest people, and one of the nicest physicians I’ve seen, but it was clear he was not steeped in MPNs, because he treated patients across a spectrum of cancers. So, in that way, I think I started out in a different place, I also know that hospitals and healthcare can be very overwhelming, and I had a bit of the language and the world and some of the sort of…I understood a little bit more, I think about what my physicians might have been sharing with me, and if I didn’t, I felt empowered and not that this is easy by any stretch and it continues to be a challenge, but I knew that I needed to ask questions. I knew that I needed to read more about my illness, I knew I needed to vet my doctor as well, and I also figured out over time that as I was going to have this illness, hopefully in the sense that I hope I continue to live well with myelofibrosis and stay alive, that I was going to be seeing an MPN expert for a long time.

So, I think that influenced my point of view, I kind of take it as a job, so as to my personality, so I have a health notebook, I need to have one from the very beginning, I knew I couldn’t remember everything, I had to write it down. I knew I had to track what I was feeling so I could share it with my doctor, and I knew that from being a health educator, I think no one told me to do those things, and certainly, physicians don’t really know to tell you that, so I think in a lot of ways, I was approaching my illness in a very serious manner because I had experience in healthcare, and the last comment I’ll make is, I think from navigating the system, navigating health insurance, I knew a little bit from my experience as a caregiver already, and also from a health educator, I understood this is another area where I needed to empower myself or ask questions, or not take some of the information that may have been shared with me initially as on face value, that it was okay to ask more. As I said, I’ve had this illness for 13 years, I’ve also been caregiving for an adult child with illness, and every time I call the insurance company to ask a question about an explanation of benefits or why something isn’t covered, and learn a tiny bit more, and I add that to sort of my toolkit.