NCCN Guidelines for Patients® | Myeloproliferative Neoplasms

28 NCCN Guidelines for Patients ® : Myeloproliferative Neoplasms, 2018 Results of cytoreductive treatment Your doctor will assess if treatment is working based on tests. There are four types of treatment response. These responses are described next. † † Complete remission is defined by 1) no cancer symptoms and signs for at least 12 weeks; 2) normal or near-normal blood counts for at least 12 weeks; 3) no blood clots or bleeding events and ET isn’t changing into another cancer; and 4) normal-looking megakaryocytes and minor, if any, bone marrow fibrosis (Grade 0 or 1). † † Partial remission is like a complete remission except abnormal-looking megakaryocytes are present. † † No response is anything less than a partial remission. † † Progressive disease is a worsening of the cancer. Changing treatment Sometimes treatment works at first then stops. Sometimes it doesn’t work enough or at all. When one treatment fails, another treatment may be received. If ET has transformed into MF or AML, read Part 5 for treatment options. If ET hasn’t transformed, changing the type of cytoreductive treatment may be needed. Signs to change your cytoreductive treatment include: † † Severe side effects, † † Treatment stops working, † † A new blood clot, † † Acquired VWD, † † Major bleeding, † † Increasing spleen size, † † Symptoms caused by enlarged spleen, † † Symptoms caused by too many platelets, † † Rising levels of white blood cells, † † Worsening MPN symptoms, and † † Aspirin isn’t relieving symptoms. 3 Essential thrombocythemia Changing treatment Available treatments have successfully controlled my counts for 25 years. When one treatment loses efficacy, I cycle to another. – Antje Survivor, Essential thrombocythemia “