NCCN Guidelines for Patients® | Myeloproliferative Neoplasms

52 NCCN Guidelines for Patients ® : Myeloproliferative Neoplasms, 2018 5 Myelofibrosis Monitoring Monitoring After initial treatment, you will need to meet with your doctor often. A visit every 3 to 6 months is advised. You may need more frequent visits if problems arise. The types of monitoring are described next. Status of MF Your doctor will assess if the cancer is worse. Blood tests may be done. Your symptoms should also be assessed. MPN-SAF Total Symptom Score may be used. If the cancer appears worse, a bone marrow aspirate and biopsy are advised. Treatment results Your doctor will assess if treatment is working based on tests. There are many types of treatment responses. These main responses are described next. † † Complete remission is the best outcome. There are no signs of the cancer. Your bone marrow and blood results are normal or near normal. Your symptoms have cleared. Your liver and spleen are normal size. † † Partial remission is a good response. Your blood work may be normal. Otherwise, your bone marrow results are normal and your blood results are returning to normal. Your symptoms have cleared. Your liver and spleen are normal size. † † Progressive disease is a worsening of the cancer. † † Stable disease is defined by results that don’t match the 3 types of responses above. You may hear of other types of responses. Anemia response is an improvement in hemoglobin level or not needing transfusions anymore. Spleen response is a major decrease in spleen size. Symptom response is a major decrease in symptoms. Clinical improvement is one or more of these responses without signs of the cancer worsening. MF may also be assessed for changes in cell structures. Cytogenetic remission is defined by fewer or the absence of abnormal chromosomes. Molecular remission is defined by fewer or the absence of molecular markers of MF. Sometimes treatment works at first then stops. This is called treatment relapse. Sometimes it doesn’t work enough or at all. When one treatment fails, another treatment may be received. Treatment options for advanced-stage MF or AML are discussed in the next section. Otherwise, read the Initial treatment section to learn treatment options based on risk groups. Our MPNs are so individual and respond differently to different treatments. – Lyn Survivor, Post-ET myelofibrosis “