Conversations in MPN is an ongoing initiative of the Canadian MPN Group that brings together healthcare practitioners, researchers, academic leaders, government representatives, and industry partners to engage in open dialogue on myeloproliferative neoplasms (MPNs). The project provides a dedicated forum to exchange knowledge, highlight emerging scientific advances, and explore the evolving landscape of MPN diagnosis, treatment, and supportive care. By fostering multidisciplinary and cross-sector discussion, it ensures that diverse perspectives inform the development of strategies that are both scientifically rigorous and aligned with real-world needs.

Through regular meetings and focused discussions, Conversations in MPN creates opportunities to address current challenges, anticipate future directions, and identify areas where collaboration can accelerate progress. Topics span from integrating genomic discoveries into clinical practice, to optimizing patient access and care delivery, to advancing clinical trial participation in Canada. By building bridges across sectors, the initiative aims not only to strengthen the MPN community but also to transform dialogue into tangible partnerships that benefit patients, providers, and the broader healthcare system.

The Tumor Board comprises a multidisciplinary core of practioners and researchers that analyzes and discusses standardized pre-board packets including: WHO/ICC diagnostic classification; marrow morphology and cytogenetics; driver (JAK2/CALR/MPL) and high-risk mutations (e.g., ASXL1, SRSF2, U2AF1Q157, EZH2, IDH1/2, TP53); symptom burden (MPN-SAF TSS 2.0); objective disease metrics (Hgb/WBC/Plt, LDH, spleen size, constitutional symptoms); thrombosis/bleeding history; pregnancy status; comorbidity/geriatric assessment; current meds (cytoreductives, antiplatelets/anticoagulants, JAK inhibitors); and patient goals/preferences.Risk is explicitly staged with disease-specific scores (ET: revised IPSET-thrombosis; PV: thrombotic risk + response/resistance criteria; MF: DIPSS/DIPSS-plus, MIPSS70(+/v2.0), GIPSS, MYSEC-PM for post-ET/PV MF).

Each case receives: (1) diagnosis confirmation; (2) risk-stratified management with guideline-concordant options (e.g., ET/PV cytoreduction with hydroxyurea or (ropeg-)peg-interferon; antithrombotic strategy; PV Hct <45% via phlebotomy vs cytoreduction; MF symptom/spleen/anemia-directed therapy with ruxolitinib/fedratinib/momelotinib/pacritinib; IDH-mutant pathways if transformed); (3) transplant eligibility/timing using standardized HCT fitness and mutation-informed risk; (4) clinical trial matching via a prescreen list keyed to genotype/phenotype; and (5) a care plan with safety monitoring (cytopenias, infections, bleeding), re-board triggers (progression, new mutations, intolerance), and shared decision summaries.

The board meets on a fixed cadence, uses a templated case synopsis, and records structured recommendations (diagnosis, risk score version/date, response criteria, trial ID). The Board discussions assess relevant indicators such as time from referral→board→treatment, trial prescreen and enrollment rates, proportion guideline-concordant decisions, transfusion/splenectomy rates, early complication rates (e.g., grade ≥3 cytopenias within 8 weeks of therapy change), unplanned admissions, and 6–12-month re-staging adherence. Additionaly, the Board targets key references such as pathology-molecular concordance, inter-rater agreement on risk scores, and outcome drift.

The Canadian MPN Group is developing a national database dedicated to myeloproliferative neoplasms (MPNs) to advance patient care, research, and collaboration across the country. This initiative will collect standardized, real-world data on diagnosis, genomic testing, treatments, outcomes, and quality-of-life measures for patients living with essential thrombocythemia, polycythemia vera, and myelofibrosis. By bringing together data from both academic centers and community practices, the database will serve as a comprehensive resource to track disease evolution, benchmark clinical practice, and identify unmet needs in the Canadian MPN landscape. Beyond clinical parameters, it will also integrate patient-reported outcomes and molecular profiles, providing a holistic understanding of MPN care and outcomes across diverse populations.

To be designed as a collaborative platform, the database will empower clinicians, researchers, and partners to generate high-quality evidence that drives both clinical excellence and innovation. Participating centers will contribute data through a secure, privacy-compliant system, supported by governance policies that ensure data integrity, consistency, and transparency. Opportunities for collaboration include contributing patient data, supporting infrastructure development, embedding clinical trials into the registry framework, and co-developing translational research projects that leverage genomic and clinical insights. Through these efforts, the Canadian MPN Group aims to accelerate discovery, enhance standards of care, and expand access to cutting-edge therapies and research opportunities for patients nationwide.

The project is positioned as an initiative that could provide valuable insights into the management of pregnant individuals with MPN, potentially leading to a better understanding of the impact of the disease during pregnancy and improving treatment strategies for this specific population.
Initiation of a Prospective Observational Study: participants interests lies on conducting a prospective observational study focused on pregnancy in individuals with MPN. The aim is to manage pregnant MPN patients according to a uniform protocol across multiple sites and obtain consensus on the management of pregnant individuals with MPN and involving input from various experts in the field.
Data Collection: the participants discusses the importance of gathering comprehensive data during pregnancy, including timing considerations for interferon usage, the role of aspirin, and dosage specifics.
Collaborative Effort: the study is positioned as a collaborative effort involving multiple sites, with participants intending to manage patients uniformly to facilitate standardized data collection.
Protocol Development: participants discusses the need to develop a protocol for the prospective observational study, outlining the specific criteria and methodologies.
Patient Management Strategies: discussions revolves around patient management strategies, such as determining when to use interferon during pregnancy and specifying the appropriate dosage of aspirin.