From the 2018 Society of Hematologic Oncology (SOHO) in Houston, TX, Srdan Verstovsek, MD, PhD, from the MD Anderson Cancer Center, Houston, TX, highlights the need to distinguish between high- and low-risk patients with essential thrombocythemia (ET). Prof. Verstovsek discusses management of ET, including the identification of differentiating prognostic factors that could inform physicians of the most effective treatment for patients. For instance, while ET patients at high-risk of thrombosis may benefit from cytoreductive therapy involving hydroxyurea and aspirin, low-risk patients do not need thi type of treatment, and may be prone to unnecessary risks. Prognostic assessment of patients have been increasingly enhanced by assessing genetic mutations, which Prof. Verstovsek hopes will be an area of advancement in clinical practice when monitoring the evolution of myeloproliferative neoplasms (MPNs). Prof. Verstovsek additionally presents findings from another talk on developments in transplantation for MPN, and the importance of early intervention before progression to AML.