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Myelodysplastic Syndrome and Myeloproliferative Neoplasms

  1. Which novel agent for polycythemia vera (PV) is currently being evaluated in the phase 3 VERIFY trial, based on the successful results of the phase 2 trial demonstrating reduced hematocrit concentration and phlebotomy dependency in patients with PV?
  2. A 73-year-old woman with a new diagnosis of higher-risk myelodysplastic syndrome (HR-MDS) has a blast count of 13%, a serum hemoglobin concentration of 8.2 g/dL, and cytogenetic test results indicating an IDH1 mutation. Although she is treatment-naive, her hematologist/oncologist encourages her to consider a clinical trial of a targeted therapy rather than undergoing standard frontline therapy with a hypomethylating agent (HMA). Which factor in this patient's presentation most likely influenced this recommendation?
    Blast count
    Hemoglobin concentration
  3. Your patient, a 66-year-old attorney with myelofibrosis, is brought to your office for a follow-up visit 8 weeks after beginning fedratinib therapy 400 mg daily. The patient's daughter reports that he has been uncharacteristically disoriented and drowsy over the past 2 weeks. Neurological exam findings confirm reduced mental alertness, slowed speech, and abnormal eye movements. Evaluation and treatment should begin with a high level of clinical suspicion for a deficiency in what nutrient?
    Folate (vitamin B12)
    Thiamine (vitamin B1)
    Vitamin D
    Vitamin E