Genetic Changes in MPN Patients

Published on

Topics include: Treatments and Understanding

Dr. Ruben Mesa explains chromosomal changes in MPN patients after the “blast phase” is reached. Dr. Mesa discusses different types of genetic tests that help to identify specific mutations and patterns in cells and whether these changes might alter the path of treatment.


View more programs featuring

Produced in association with

Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of MD Anderson Cancer Center, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Woman:
Back to the previous slide on the blast phase, can you speak to the relevance of chromosome 5 falling out when that phase is reached?

Dr. Mesa:
So as we think about the genetic changes, there are different levels of genetic changes. One, we can try to go in and analyze whether there is one specific mutation in the blood or not, so like the JAK2 mutation, of which there is more than one test, but they can see whether that genetic change is present or not. There’s another level of genetic testing that is a bit more from the 20,000-foot view, which are the chromosomes.

These are tests typically done from the bone marrow where the cells from the bone marrow are grown in a Petrie dish, and they look at the chromosomes at the time of mitosis. That’s when the cell grows and divides.

And there is a normal pattern that we have in normal cells. In patients with MPNs, we can see chromosome changes, whether there is a chromosome break, whether there is a chromosome piece that isn’t there that’s supposed to be, and that’s a factor in many different diseases. We know overall that having chromosome changes are present probably in I would say 30 to 40 percent of patients with MPNs as a whole—probably less common in ET and P Vera—but certainly they can occur.

We know as people tend to progress—particularly towards acute leukemia—we tend to see people having more chromosome changes than when they started. So if we look at a bone marrow at the time of someone having acute leukemia versus the time of diagnosis, many individuals will now have chromosome changes that did not have them before. There are certain chromosome changes anywhere along the way that do give us a little greater concern about changes in the disease.

It doesn’t mean they’re a guarantee, but there are some changes. Changes in chromosome 7, changes in chromosome 5 in some individuals can be a concern. It depends on what change there. But more than individual chromosome changes, probably the strongest driver is having multiple chromosome changes at the same time.

People who have three changes or more, that just shows that the genes in the bone marrow are not as stable as we would like them to be. There are times that a change in chromosome five sometimes can actually have an impact on choice of therapy, as well.

Andrew Schorr:      
What I’m hearing from you, Dr. Mesa, is right now, you’re still learning the significance of some of these chromosome changes, genetic changes, trying to figure it out. But for somebody to worry tremendously about just one change, you wouldn’t recommend that.

Dr. Mesa:    
Right.

Please remember the opinions expressed on Patient Power are not necessarily the views of MD Anderson Cancer Center, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

 

 

Related Programs

Combination Therapy for MPN Patients

Are better drugs on the horizon for MPNs? Dr. Ruben Mesa, deputy director at Mayo Clinic Cancer Center, provides an update on where we are with single agents and combination therapy in fighting MPNs.

Published:

Myeloproliferative Neoplasms (MPNs): What Are the Demographics?

Are there any similarities among patients with MPNs? Dr. Ruben Mesa walks us through some of the demographics for myelofibrosis neoplasms while addressing various symptoms and stages of the disease.

Published:

Living Stronger and Longer with MPNs

Mayo Clinic expert Dr. Ruben Mesa shares his thoughts on how treatment and research can be further improved for patients living with MPNs.

Published:

Advertisement
Join Our Community Register for Events Read Our Latest Blog
Advertisement

Page last updated on April 1, 2014