ROP-ET: a prospective phase III trial investigating the efficacy and safety of ropeginterferon alfa-2b in essential thrombocythemia patients with limited treatment options.

Disease modification Essential thrombocythemia (ET) Myeloproliferative neoplasms (MPNs) Phase III ROP-ET Ropeginterferon alfa-2b

Journal

Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334

Informations de publication

Date de publication:
04 Mar 2024
Historique:
received: 12 01 2024
accepted: 15 02 2024
medline: 5 3 2024
pubmed: 5 3 2024
entrez: 4 3 2024
Statut: aheadofprint

Résumé

Interferon-based therapies, such as ropeginterferon alfa-2b have emerged as promising disease-modifying agents for myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET). Current ET treatments aim to normalize hematological parameters and reduce the thrombotic risk, but they do not modify the natural history of the disease and hence, have no impact on disease progression. Ropeginterferon alfa-2b (trade name BESREMi®), a novel, monopegylated interferon alfa-2b with an extended administration interval, has demonstrated a robust and sustained efficacy in polycythemia vera (PV) patients. Given the similarities in disease pathophysiology and treatment goals, ropeginterferon alfa-2b holds promise as a treatment option for ET. The ROP-ET trial is a prospective, multicenter, single-arm phase III study that includes patients with ET who are intolerant or resistant to, and/or are ineligible for current therapies, such as hydroxyurea (HU), anagrelide (ANA), busulfan (BUS) and pipobroman, leaving these patients with limited treatment options. The primary endpoint is a composite response of hematologic parameters and disease-related symptoms, according to modified European LeukemiaNet (ELN) criteria. Secondary endpoints include improvements in symptoms and quality of life, molecular response and the safety profile of ropeginterferon alfa-2b. Over a 3-year period the trial assesses longer term outcomes, particularly the effects on allele burden and clinical outcomes, such as disease-related symptoms, vascular events and disease progression. No prospective clinical trial data exist for ropeginterferon alfa-2b in the planned ET study population and this study will provide new findings that may contribute to advancing the treatment landscape for ET patients with limited alternatives. TRIAL REGISTRATION: EU Clinical Trials Register; EudraCT, 2023-505160-12-00; Registered on October 30, 2023.

Identifiants

pubmed: 38438627
doi: 10.1007/s00277-024-05665-4
pii: 10.1007/s00277-024-05665-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

Kiladjian JJ, Cassinat B, Chevret S et al (2008) Pegylated interferon-alfa-2a induces complete hematologic and molecular responses with low toxicity in polycythemia vera. Blood 112(8):3065–3072. https://doi.org/10.1182/blood-2008-03-143537
doi: 10.1182/blood-2008-03-143537 pubmed: 18650451
Masarova L, Patel KP, Newberry KJ et al (2017) Pegylated interferon alfa-2a in patients with essential thrombocythaemia or polycythaemia vera: a post-hoc, median 83 month follow-up of an open-label, phase 2 trial. Lancet Haematol 4(4):e165–e175. https://doi.org/10.1016/S2352-3026(17)30030-3
doi: 10.1016/S2352-3026(17)30030-3 pubmed: 28291640 pmcid: 5421384
Knudsen TA, Hansen DL, Ocias LF et al (2018) Long-term efficacy and safety of recombinant interferon alpha-2 vs. hydroxyurea in polycythemia vera: preliminary results from the three-year analysis of the Daliah Trial - a randomized controlled phase III clinical trial. Blood 132(no Suppl 1):pp580. https://doi.org/10.1182/blood-2018-99-111255
doi: 10.1182/blood-2018-99-111255
Yacoub A, Mascarenhas J, Kosiorek H et al (2019) Pegylated interferon alfa-2a for polycythemia vera or essential thrombocythemia resistant or intolerant to hydroxyurea. Blood 134(18):1498–1509. https://doi.org/10.1182/blood.2019000428
doi: 10.1182/blood.2019000428 pubmed: 31515250 pmcid: 6839950
Gisslinger H, Klade C, Georgiev P et al (2020) Ropeginterferon alfa-2b versus standard therapy for polycythaemia vera (PROUD-PV and CONTINUATION-PV): a randomised, non-inferiority, phase 3 trial and its extension study. Lancet Haematol 7(3):e196–e208. https://doi.org/10.1016/S2352-3026(19)30236-4
doi: 10.1016/S2352-3026(19)30236-4 pubmed: 32014125
Mascarenhas J, Kosiorek HE, Prchal JT et al (2022) A randomized phase 3 trial of interferon-alpha vs hydroxyurea in polycythemia vera and essential thrombocythemia. Blood 139(19):2931–2941. https://doi.org/10.1182/blood.2021012743
doi: 10.1182/blood.2021012743 pubmed: 35007321 pmcid: 9101248
Barbui T, Vannucchi AM, De Stefano V et al (2023) Ropeginterferon versus standard therapy for low-risk patients with polycythemia vera. NEJM Evid 2(6). https://doi.org/10.1056/EVIDoa2200335
Gisslinger H, Klade C, Georgiev P et al (2023) Event-free survival in patients with polycythemia vera treated with ropeginterferon alfa-2b versus best available treatment. Leukemia. https://doi.org/10.1038/s41375-023-02008-6
doi: 10.1038/s41375-023-02008-6 pubmed: 37634011 pmcid: 10539163
Kiladjian JJ, Klade C, Georgiev P et al (2022) Long-term outcomes of polycythemia vera patients treated with ropeginterferon Alfa-2b. Leukemia 36(5):1408–1411. https://doi.org/10.1038/s41375-022-01528-x
doi: 10.1038/s41375-022-01528-x pubmed: 35210530 pmcid: 9061291
Hasselbalch HC, Holmstrom MO (2019) Perspectives on interferon-alpha in the treatment of polycythemia vera and related myeloproliferative neoplasms: minimal residual disease and cure? Semin Immunopathol 41(1):5–19. https://doi.org/10.1007/s00281-018-0700-2
doi: 10.1007/s00281-018-0700-2 pubmed: 30203226
Abu-Zeinah G, Silver RT, Abu-Zeinah K et al (2021) Normal life expectancy for polycythemia vera (PV) patients is possible. Leukemia 36(2):569–572. https://doi.org/10.1038/s41375-021-01447-3
doi: 10.1038/s41375-021-01447-3 pubmed: 34625712
How J, Garcia JS, Mullally A (2023) Biology and therapeutic targeting of molecular mechanisms in MPNs. Blood 141(16):1922–1933. https://doi.org/10.1182/blood.2022017416
doi: 10.1182/blood.2022017416 pubmed: 36534936
Verger E, Soret-Dulphy J, Maslah N et al (2018) Ropeginterferon alpha-2b targets JAK2V617F-positive polycythemia vera cells in vitro and in vivo. Blood Cancer J 8(10):94. https://doi.org/10.1038/s41408-018-0133-0
doi: 10.1038/s41408-018-0133-0 pubmed: 30287855 pmcid: 6172224
How J, Hobbs G (2022) Interferons as the first choice of cytoreduction in essential thrombocythemia and polycythemia vera. J Natl Compr Canc Netw 20(9):1063–1068. https://doi.org/10.6004/jnccn.2022.7026
doi: 10.6004/jnccn.2022.7026 pubmed: 36075385
Godfrey AL, Green AC, Harrison CN (2023) Essential thrombocythemia: challenges in clinical practice and future prospects. Blood 141(16):1943–1953. https://doi.org/10.1182/blood.2022017625
doi: 10.1182/blood.2022017625 pubmed: 36379024
Masarova L, Verstovsek S (2019) Emerging drugs for essential thrombocythemia. Expert Opin Emerg Drugs 24(2):93–105. https://doi.org/10.1080/14728214.2019.1615437
doi: 10.1080/14728214.2019.1615437 pubmed: 31050912
Birgegard G, Besses C, Griesshammer M et al (2018) Treatment of essential thrombocythemia in Europe: a prospective long-term observational study of 3649 high-risk patients in the evaluation of anagrelide efficacy and long-term safety study. Haematologica 103(1):51–60. https://doi.org/10.3324/haematol.2017.174672
doi: 10.3324/haematol.2017.174672 pubmed: 29079600 pmcid: 5777190
Gisslinger H, Gotic M, Holowiecki J et al (2013) Anagrelide compared with hydroxyurea in WHO-classified essential thrombocythemia: the ANAHYDRET Study, a randomized controlled trial. Blood 121(10):1720–1728. https://doi.org/10.1182/blood-2012-07-443770
doi: 10.1182/blood-2012-07-443770 pubmed: 23315161 pmcid: 3591796
Tefferi A, Vannucchi AM, Barbui T (2018) Essential thrombocythemia treatment algorithm 2018. Blood Cancer J 8(1):2. https://doi.org/10.1038/s41408-017-0041-8
doi: 10.1038/s41408-017-0041-8 pubmed: 29321520 pmcid: 5802626
Alvarez-Larran A, Martinez-Aviles L, Hernandez-Boluda JC et al (2014) Busulfan in patients with polycythemia vera or essential thrombocythemia refractory or intolerant to hydroxyurea. Ann Hematol 93(12):2037–2043. https://doi.org/10.1007/s00277-014-2152-7
doi: 10.1007/s00277-014-2152-7 pubmed: 24981691
Hernandez-Boluda JC, Alvarez-Larran A, Gomez M et al (2011) Clinical evaluation of the European LeukaemiaNet criteria for clinicohaematological response and resistance/intolerance to hydroxycarbamide in essential thrombocythaemia. Br J Haematol 152(1):81–88. https://doi.org/10.1111/j.1365-2141.2010.08430.x
doi: 10.1111/j.1365-2141.2010.08430.x pubmed: 21083657
Birgegard G (2016) The use of anagrelide in myeloproliferative neoplasms, with focus on essential thrombocythemia. Curr Hematol Malig Rep 11(5):348–355. https://doi.org/10.1007/s11899-016-0335-0
doi: 10.1007/s11899-016-0335-0 pubmed: 27497846 pmcid: 5031713
Arber DA, Orazi A, Hasserjian R et al (2016) The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 127(20):2391–2405. https://doi.org/10.1182/blood-2016-03-643544
doi: 10.1182/blood-2016-03-643544 pubmed: 27069254
Barosi G, Besses C, Birgegard G et al (2007) A unified definition of clinical resistance/intolerance to hydroxyurea in essential thrombocythemia: results of a consensus process by an international working group. Leukemia 21(2):277–280. https://doi.org/10.1038/sj.leu.2404473
doi: 10.1038/sj.leu.2404473 pubmed: 17251900
Barosi G, Mesa R, Finazzi G et al (2013) Revised response criteria for polycythemia vera and essential thrombocythemia: an ELN and IWG-MRT consensus project. Blood 121(23):4778–4781. https://doi.org/10.1182/blood-2013-01-478891
doi: 10.1182/blood-2013-01-478891 pubmed: 23591792 pmcid: 3674675
Stegelmann F, Teichmann LL, Heidel FH et al (2023) Clinicohematologic and molecular response of essential thrombocythemia patients treated with pegylated interferon-alpha: a multi-center study of the German Study Group-Myeloproliferative Neoplasms (GSG-MPN). Leukemia 37(4):924–928. https://doi.org/10.1038/s41375-023-01837-9
doi: 10.1038/s41375-023-01837-9 pubmed: 36828867 pmcid: 10079540
ICH Harmonised Tripartite Guideline (1999) Statistical principles for clinical trials, international conference on harmonisation E9 Expert Working Group Stat Med 18(15):1905–1942. https://www.ncbi.nlm.nih.gov/pubmed/10532877
Gilreath JA, Tashi T, Kim SJ et al (2018) Compassionate use of ropeginterferon-alfa-2b/P1101 for treatment of high risk polycythemia vera and essential thrombocythemia patients previously controlled on pegylated interferon-alfa-2a/Pegasys®. Blood 132(Supplement 1):5459–5459. https://doi.org/10.1182/blood-2018-99-116852
doi: 10.1182/blood-2018-99-116852
How J, Hobbs G (2022) Real-world experience of ropeginterferon in myeloproliferative neoplasm patients. Blood 140(Supplement 1):12284–12285. https://doi.org/10.1182/blood-2022-157076
doi: 10.1182/blood-2022-157076
Huang CE, Wu YY, Hsu CC et al (2021) Real-world experience with ropeginterferon-alpha 2b (Besremi) in philadelphia-negative myeloproliferative neoplasms. J Formos Med Assoc 120(2):863–873. https://doi.org/10.1016/j.jfma.2020.08.021
doi: 10.1016/j.jfma.2020.08.021 pubmed: 32873465
Novak W, Annamária C, Crazzolara R et al (2022) Severe complications in JAK2 V617F positive pediatric patients with myeloproliferative neoplasms. Hemasphere 6(Suppl):936–937. https://doi.org/10.1097/01.HS9.0000852292.38263.b8
doi: 10.1097/01.HS9.0000852292.38263.b8 pmcid: 9429437
Okikiolu J, Woodley C, Cadman-Davies L et al (2023) Real world experience with ropeginterferon alpha-2b (Besremi) in essential thrombocythaemia and polycythaemia vera following exposure to pegylated interferon alfa-2a (Pegasys). Leuk Res Rep 19:100360. https://doi.org/10.1016/j.lrr.2022.100360
doi: 10.1016/j.lrr.2022.100360 pubmed: 36590864
Podstavková N, Weinbergerová B, Procházková J et al (2022) Current experience with ropeginterferon Alfa-2b in Ph negative myeloproliferative neoplasm at the Department of Internal Medicine – Haematology and Oncology in Brno. Transfuze Hematol Dnes 28(4):1–6. https://doi.org/10.48095/cctahd2022prolekare.cz15
doi: 10.48095/cctahd2022prolekare.cz15
Tashi T, Reeves BN, Kim SJ et al (2023) Real-world experience of ropeginterferon-alfa treatment of PV and ET - Two centers experience. Blood 142(Supplement 1):6397. https://doi.org/10.1182/blood-2023-191268
doi: 10.1182/blood-2023-191268
Barbui T, Tefferi A, Vannucchi AM et al (2018) Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet. Leukemia 32(5):1057–1069. https://doi.org/10.1038/s41375-018-0077-1
doi: 10.1038/s41375-018-0077-1 pubmed: 29515238 pmcid: 5986069
Alvarez-Larran A, Sant’Antonio E, Harrison C et al (2021) Unmet clinical needs in the management of CALR-mutated essential thrombocythaemia: a consensus-based proposal from the European LeukemiaNet. Lancet Haematol 8(9):e658–e665. https://doi.org/10.1016/S2352-3026(21)00204-0
doi: 10.1016/S2352-3026(21)00204-0 pubmed: 34450103
Mesa RA, Jamieson C, Bhatia R et al (2017) NCCN guidelines insights: Myeloproliferative neoplasms, version 2.2018. J Natl Compr Canc Netw 15(10):1193–1207. https://doi.org/10.6004/jnccn.2017.0157
doi: 10.6004/jnccn.2017.0157 pubmed: 28982745
Bewersdorf JP, Giri S, Wang R et al (2021) Interferon alpha therapy in essential thrombocythemia and polycythemia vera-a systematic review and meta-analysis. Leukemia 35(6):1643–1660. https://doi.org/10.1038/s41375-020-01020-4
doi: 10.1038/s41375-020-01020-4 pubmed: 32868875
Gu W, Yang R, Xiao Z et al (2021) Clinical outcomes of interferon therapy for polycythemia vera and essential thrombocythemia: a systematic review and meta-analysis. Int J Hematol 114(3):342–354. https://doi.org/10.1007/s12185-021-03171-1
doi: 10.1007/s12185-021-03171-1 pubmed: 34091876
Beauverd Y, Ianotto J-C, Thaw KH et al (2023) Impact of cytoreductive drugs upon outcomes in a contemporary cohort of adolescent and young adults with essential thrombocythemia and polycythemia vera. Retrieved from https://ash.confex.com/ash/2023/webprogram/Paper185108.html . Accessed 27 Nov 2023
Alvarado Y, Cortes J, Verstovsek S et al (2003) Pilot study of pegylated interferon-alpha 2b in patients with essential thrombocythemia. Cancer Chemother Pharmacol 51(1):81–86. https://doi.org/10.1007/s00280-002-0533-4
doi: 10.1007/s00280-002-0533-4 pubmed: 12497210
Langer C, Lengfelder E, Thiele J et al (2005) Pegylated interferon for the treatment of high risk essential thrombocythemia: results of a phase II study. Haematologica 90(10):1333–1338
pubmed: 16219569
Verger E, Cassinat B, Chauveau A et al (2015) Clinical and molecular response to interferon-alpha therapy in essential thrombocythemia patients with CALR mutations. Blood 126(24):2585–2591. https://doi.org/10.1182/blood-2015-07-659060
doi: 10.1182/blood-2015-07-659060 pubmed: 26486786
Gowin K, Thapaliya P, Samuelson J et al (2012) Experience with pegylated interferon alpha-2a in advanced myeloproliferative neoplasms in an international cohort of 118 patients. Haematologica 97(10):1570–1573. https://doi.org/10.3324/haematol.2011.061390
doi: 10.3324/haematol.2011.061390 pubmed: 22419578 pmcid: 3487558
Gowin K, Jain T, Kosiorek H et al (2017) Pegylated interferon alpha – 2a is clinically effective and tolerable in myeloproliferative neoplasm patients treated off clinical trial. Leuk Res 54:73–77. https://doi.org/10.1016/j.leukres.2017.01.006
doi: 10.1016/j.leukres.2017.01.006 pubmed: 28113109
Jabbour E, Kantarjian H, Cortes J et al (2007) PEG-IFN-alpha-2b therapy in BCR-ABL-negative myeloproliferative disorders: final result of a phase 2 study. Cancer 110(9):2012–2018. https://doi.org/10.1002/cncr.23018
doi: 10.1002/cncr.23018 pubmed: 17849460
Samuelsson J, Hasselbalch H, Bruserud O et al (2006) A phase II trial of pegylated interferon alpha-2b therapy for polycythemia vera and essential thrombocythemia: feasibility, clinical and biologic effects, and impact on quality of life. Cancer 106(11):2397–2405. https://doi.org/10.1002/cncr.21900
doi: 10.1002/cncr.21900 pubmed: 16639737
Verstovsek S, Komatsu N, Gill H et al (2022) SURPASS-ET: phase III study of ropeginterferon alfa-2b versus anagrelide as second-line therapy in essential thrombocythemia. Future Oncol 18(27):2999–3009. https://doi.org/10.2217/fon-2022-0596
doi: 10.2217/fon-2022-0596 pubmed: 35924546
Masarova L, Mascarenhas J, Qin A et al (2023) EXCEED-ET: a single-arm multicenter study to assess the efficacy, safety, and tolerability of ropeginterferon alfa-2b-njft (P1101) in north American adults with essential thrombocythemia. J Clin Oncol 41(16):TPS7088–TPS7088. https://doi.org/10.1200/JCO.2023.41.16_suppl.TPS7088
doi: 10.1200/JCO.2023.41.16_suppl.TPS7088
Gisslinger H, Zagrijtschuk O, Buxhofer-Ausch V et al (2015) Ropeginterferon alfa-2b, a novel IFNalpha-2b, induces high response rates with low toxicity in patients with polycythemia vera. Blood 126(15):1762–1769. https://doi.org/10.1182/blood-2015-04-637280
doi: 10.1182/blood-2015-04-637280 pubmed: 26261238 pmcid: 4608390
Edahiro Y, Ohishi K, Gotoh A et al (2022) Efficacy and safety of ropeginterferon alfa-2b in Japanese patients with polycythemia vera: an open-label, single-arm, phase 2 study. Int J Hematol 116(2):215–227. https://doi.org/10.1007/s12185-022-03341-9
doi: 10.1007/s12185-022-03341-9 pubmed: 35430707
Ferrer-Marin F, Arroyo AB, Bellosillo B et al (2020) miR-146a rs2431697 identifies myeloproliferative neoplasm patients with higher secondary myelofibrosis progression risk. Leukemia 34(10):2648–2659. https://doi.org/10.1038/s41375-020-0767-3
doi: 10.1038/s41375-020-0767-3 pubmed: 32107471
Hasselbalch HC, Bjorn ME (2015) MPNs as inflammatory diseases: the evidence, consequences, and perspectives. Mediators Inflamm 2015:102476. https://doi.org/10.1155/2015/102476
doi: 10.1155/2015/102476 pubmed: 26604428 pmcid: 4641200
Morales ML, Ferrer-Marin F (2023) Deepening our understanding of the factors affecting landscape of myeloproliferative neoplasms: what do we know about them? Cancers (Basel) 15(4). https://doi.org/10.3390/cancers15041348
Guy A, Favre S, Labrouche-Colomer S et al (2019) High circulating levels of MPO-DNA are associated with thrombosis in patients with MPN. Leukemia 33(10):2544–2548. https://doi.org/10.1038/s41375-019-0500-2
doi: 10.1038/s41375-019-0500-2 pubmed: 31175322
Schmidt S, Daniliants D, Hiller E et al (2021) Increased levels of NETosis in myeloproliferative neoplasms are not linked to thrombotic events. Blood Adv 5(18):3515–3527. https://doi.org/10.1182/bloodadvances.2020004061
doi: 10.1182/bloodadvances.2020004061 pubmed: 34464975 pmcid: 8945589
Ferrer-Marin F, Cuenca-Zamora EJ, Guijarro-Carrillo PJ et al (2021) Emerging role of neutrophils in the thrombosis of chronic myeloproliferative neoplasms. Int J Mol Sci 22(3). https://doi.org/10.3390/ijms22031143
Marin Oyarzun CP, Carestia A, Lev PR et al (2016) Neutrophil extracellular trap formation and circulating nucleosomes in patients with chronic myeloproliferative neoplasms. Sci Rep 6:38738. https://doi.org/10.1038/srep38738
doi: 10.1038/srep38738 pubmed: 27958278 pmcid: 5153854
Wolach O, Sellar RS, Martinod K et al (2018) Increased neutrophil extracellular trap formation promotes thrombosis in myeloproliferative neoplasms. Sci Transl Med 10(436). https://doi.org/10.1126/scitranslmed.aan8292

Auteurs

Jean-Jacques Kiladjian (JJ)

CIC 1427, Inserm, Université Paris Cité, 75010, Paris, France. jean-jacques.kiladjian@aphp.fr.
Centre d'Investigations Cliniques, AP-HP, Hôpital Saint-Louis, Paris, 75010, France. jean-jacques.kiladjian@aphp.fr.

Francisca Ferrer Marin (FF)

Morales Meseguer University General Hospital, Regional Center of Blood Donation. CIBERER. UCAM. IMIB-Murcia, Murcia, Spain.

Haifa Kathrin Al-Ali (HK)

University Hospital Halle (Saale), Krukenberg Cancer Center Halle, Halle, Germany.

Alberto Alvarez-Larrán (A)

Department of Hematology, Hospital Clínic of Barcelona, Barcelona, Spain.

Eloise Beggiato (E)

University Hospital City of Health and Science of Turin - Hospital Molinette, Complex Structure of Hematology, Torino, Italy.

Maria Bieniaszewska (M)

Medical University of Gdańsk, Gdańsk, Poland.

Massimo Breccia (M)

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Veronika Buxhofer-Ausch (V)

Department of Internal Medicine I for Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Johannes Kepler University Linz, Linz, Austria.
Medical Faculty, Johannes Kepler University Linz, Linz, Austria.

Olga Cerna (O)

Clinic of Internal Hematology, University Hospital Kralovske Vinohrady, Prague, Czech Republic.

Ana-Manuela Crisan (AM)

Fundeni Clinical Institute, Center for Hematology and Bone Marrow Transplantation, București, Romania.

Catalin Doru Danaila (CD)

Department of Clinical Hematology, Regional Institute of Oncology, Iasi, Romania.

Valerio De Stefano (V)

Fondazione Policlinico Gemelli IRCCS, Section of Hematology, Catholic University, Rome, Italy.

Konstanze Döhner (K)

Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.

Victoria Empson (V)

AOP Health, Vienna, Austria.

Joanna Gora-Tybor (J)

Department of Hematooncology, Copernicus Memorial Hospital, Lodz, Poland.
Department of Hematology, Medical University of Lodz, Lodz, Poland.

Martin Griesshammer (M)

Department of Oncology and Hematology, Ruhr University Bochum, Johannes Wesling Hospital Minden, Minden, Germany.

Sebastian Grosicki (S)

Medical University of Silesia, Katowice, Poland.

Paola Guglielmelli (P)

Department of Hematology, Careggi University Hospital, Florence, Italy.

Valentin García-Gutierrez (V)

Hospital Universitario Ramón y Cajal, Madrid (IRYCIS), Madrid, Spain.
Universidad de Alcalá, Madrid, Spain.

Florian H Heidel (FH)

Clinic for Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School (MHH), Hannover, Germany.

Arpád Illés (A)

Faculty of Medicine, Department of Internal Medicine, Division of Hematology, University of Debrecen, Debrecen, Hungary.

Ciprian Tomuleasa (C)

Ion Chiricuta Institute of Oncology, Hematology Department and Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Chloe James (C)

University Bordeaux, INSERM, BMC, U1034, F-33600, Pessac, France.
Laboratory of Hematology, Bordeaux University Hospital, Bordeaux, France.

Steffen Koschmieder (S)

Faculty of Medicine, Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation (Medical Clinic IV), RWTH Aachen University, Aachen, Germany.

Maria-Theresa Krauth (MT)

Department of Internal Medicine I, Clinical Department of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.

Kurt Krejcy (K)

AOP Health, Vienna, Austria.

Mihaela-Cornelia Lazaroiu (MC)

Department of Hematology, Policlinica de Diagnostic Rapid Brasov, Brasov, Romania.

Jiri Mayer (J)

University Hospital Brno, Department of Internal Medicine, Hematology and Oncology, Masaryk University, Brno, Czech Republic.

Zsolt György Nagy (ZG)

Department of Internal Medicine and Hematology, Division of Hematology, Semmelweis University, Budapest, Hungary.

Franck-Emmanuel Nicolini (FE)

Centre Léon Bérard, Lyon, France.

Francesca Palandri (F)

IRCCS Azienda Ospedaliero-Universitaria di Bologna and Istituto di Ematologia Seràgnoli, Bologna, Italy.

Vassiliki Pappa (V)

University General Hospital Attikon, Athens, Greece.

Andreas Johannes Reiter (AJ)

Medical Clinic III, Hematology and Internistic Oncology, University Hospital Mannheim, Mannheim, Germany.

Tomasz Sacha (T)

Department of Hematology, Jagiellonian University Hospital, Kraków, Poland.

Stefanie Schlager (S)

AOP Health, Vienna, Austria.

Stefan Schmidt (S)

Department of Internal Medicine V (Hematology and Oncology), Medical University Innsbruck, Innsbruck, Austria.

Evangelos Terpos (E)

Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Martin Unger (M)

AOP Health, Vienna, Austria.

Albert Wölfler (A)

Department of Internal Medicine, Clinical Divison of Hematology, Medical University Graz, Graz, Austria.

Blanca Xicoy Cirici (BX)

Institut Català d' Oncologia- Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.

Christoph Klade (C)

AOP Health, Vienna, Austria.

Classifications MeSH