Essential Thrombocythemia Clinical Trial
Official title:
A Study of 18F-FLT Positron Emission Tomography/Computed Tomography (PET/CT) Imaging in Cases of Prefibrotic/Early Primary Myelofibrosis (PMF) and Essential Thrombocythemia (ET)
The main purpose of this project is to study the uptake pattern of FLT-PET in cases, and it
is value in assessing the malignant hematopoiesis in cases of Pre-PMF and ET, regarding
diagnosis, staging and monitoring response to therapy. Identifying different patterns of
uptake in patients with Pre-PMF and ET in various clinical settings.
Evaluating FLT-PET as a novel non-invasive technique in cases with Pre-PMF and ET, in
comparison to the standard bone marrow biopsy about disease diagnosis, assessment of disease
activity, detection of transformation, monitoring of treatment response and grading of
fibrosis.Study the ability of FLT-PET to differentiate between Pre-PMF and ET.
the investigators also aim to examine the association of FLT-PET uptake patterns with
different genetic makeup (JAK2 (Janus kinase 2), CALR (Calreticulin), MPL (myeloproliferative
leukemia protein), or Triple negative disease) or allele burden in cases of Pre-PMF and ET.
PET with fluorodeoxy glucose combined with computed tomography is a major tool for the
diagnosis, staging, and monitoring of treatment response in clinical oncology.
3'-18Fluoro-3'-deoxy-L-thymidine (18F-FLT) is a PET radiotracer that quickly accumulates in
proliferating cells and can be used to assess tumor cell proliferation in various cancers as
PET radiotracer offers a non-invasive assessment of cell proliferation in vivo.
Myeloproliferative Neoplasms (MPNs) are clonal hematopoietic stem disorders characterized by
high rate of effective proliferation of one or more cell lineage. MPNs are overlapping
syndromes that can progress to fibrotic stage or evolute into acute leukemia. Preliminary
results of a pilot study (5) suggested that this technique could be useful to assess bone
marrow (BM) activity and extramedullary hematopoiesis in patients with Myelofibrosis (MF).
The current standard for follow- up of these patients is based on pathological markers
(peripheral blood counts and/ bone marrow histomorphology) and molecular markers. Although,
bone marrow examination could be considered as a standard gold method as it gives detailed
information about cellularity, the morphology of each lineage, a degree of fibrosis,
transformation and dysplastic features. However, many patients are reluctant to go for this
invasive technique which precludes precise assessment of disease activity at the desirable
frequencies. Non- invasive techniques which may act as the good clinical surrogate are
lacking.
The objective of this study is to study the uptake pattern of FLT-PET in cases, and it is
value in assessing the malignant hematopoiesis in cases of Pre-PMF and ET, regarding
diagnosis, staging and monitoring response to therapy.
Identifying different patterns of uptake in patients with Pre-PMF and ET in various clinical
settings.
Evaluating FLT-PET as a novel non-invasive technique in cases with Pre-PMF and ET, in
comparison to the standard bone marrow biopsy about disease diagnosis, assessment of disease
activity, detection of transformation, monitoring of treatment response and grading of
fibrosis.
Study the ability of FLT-PET to differentiate between Pre-PMF and ET. the investigators also
aim to investigate the association of FLT-PET uptake patterns with different genetic makeup
(JAK2, CALR, MPL, or Triple negative disease) or allele burden in cases of Pre-PMF and ET.
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