Modified Delphi Process to Develop Best Practice Recommendations for Myelofibrosis Management in Routine Clinical Practice in the Asia-Pacific Region (The APAC-MF Alliance)

• Published in: Blood 2024-11, Vol.144, p.3678-3678
• Main Authors: Gill, Harinder, Choi, Chul Won, Than, Hein, Hou, Hsin-An, Jung, Chul Won, Kwong, Yok-Lam, Leung, Garret M. K., Ooi, Melissa G. M., Rojnuckarin, Ponlapat, Ross, David M., Shih, Lee-Yung, Takenaka, Katsuto, Teo, Winnie Z. Y., Kirito, Keita
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-201402

Background: While international treatment guidelines for myelofibrosis (MF) have contributed to the standardization of best clinical practice and patient care globally, a need remains in the Asia-Pacific (APAC) region for treatment recommendations that take into account local epidemiology, healthcare infrastructure, and resource availability. In response, a Steering Committee (SC) of expert hematologists from Asia and Australia developed consensus statements (CSs) to optimize MF treatment in the APAC region. Herein, we present updated results of the program following the final round of extended faculty (EF) voting. Objectives: To develop APAC region-specific, evidence- and consensus-based recommendations for routine MF management, which offer practical strategies to support clinicians and guide therapeutic decision-making. Methods: A modified Delphi methodology was used to draft and agree CSs in response to 13 clinical questions representing unmet needs in the management of patients with MF in the APAC region. An SC was formed of 14 expert APAC hematologists who identified these questions across four themes: 1) thresholds for anemia, and when to initiate or modify treatment; 2) when to initiate or modify treatment for thrombocytopenia; 3) Janus kinase inhibitor failure and what would warrant switching treatment; and, 4) appropriate risk stratification models for MF in the APAC region. Findings from a systematic literature review, along with clinical insights of the SC, were used to draft the CSs. An APAC EF, including expert hematologists and representatives from patient advocacy groups, voted on the CSs, with consensus reached when 75% of respondents agreed within a range of 7-9 on a 9-point scale (1=strongly disagree, 9=strongly agree). Voters scoring