ImetelChat

This from one of the upcoming EHA abstracts: "Among 57 pts with available bone marrow data, 19 pts (33%) had ≥1 degree of bone marrow fibrosis improvement while on study and had a significant longer OS than those who had worsening bone marrow fibrosis (HR=0.36, 95% CI 0.13-0.96 p=0.04). A similar trend was seen in 30 pts (53%) with stable vs. worsening fibrosis (HR=0.47, 95% CI 0.19-1.20)."

So we see reversal of bone marrow fibrosis clearly affecting the course of the disease. It is notable that these patients are near the end of their lives. It seems Herculean to try to reverse here yet we see it. I anticipate some discussion as to why the heck don't they start earlier in the course of the disease. What is wrong with them that we have to endure years more study after the failure of other agents???? I don't think Rux helps anemia much. These MF patients will still experience bone marrow failure until they can get Imetelstat. What's up with that? I have already submitted my questions and I think the IR dept is sick of hearing from me but perhaps one of you can submit in case they limit the number of questions allowed from each person (which they have done before). Dr. Rizzo seems quite pleased to be able to correlate reversal of fibrosis with regression of symptoms and OS. She should be-- its a heck of an accomplishment. If you have ever looked at fibrotic bone marrow under the microscope, its like looking at concrete. That there could be reversal is remarkable indeed but why not start sooner? Many have asked this question before without a satisfactory answer, perhaps Dr. Rizzo could provide one, she almost certainly knows the answer. bp

Probably one of the most accurate and direct observations I've seen posted with regards to a delay in treatment with Imetelstat as far as the patients are concerned. Bravo Andrew for your sensible understanding of patient needs, while current options are driving them into poor prognosis. FDA and EMA hurdles placed before Imetelstat seemingly disregard any benefit in the early stages of this disease. Kind of suspicious since that's where you would think they would want to target these studies, given the already known inferior results of Rux. I will gladly submit questions regarding this topic to IR with your guidance of course. And may I suggest others here more knowledgeable than myself do the same. Thanks for words of wisdom and a forum geared towards positive discussion and awareness. Keep up the good work here! -Kmall

Kmall, from what I have seen of you, you certainly do not need my guidance! Go for it. I look forward to the day when you tell us you are buying a bigger boat...bp