TY - JOUR
T1 - A dynamic prognostic model to predict survival in primary myelofibrosis
T2 - A study by the IWG-MRT (International Working Group for Myeloproliferative Neoplasms Research and Treatment)
AU - Passamonti, Francesco
AU - Cervantes, Francisco
AU - Vannucchi, Alessandro Maria
AU - Morra, Enrica
AU - Rumi, Elisa
AU - Pereira, Arturo
AU - Guglielmelli, Paola
AU - Pungolino, Ester
AU - Caramella, Marianna
AU - Maffioli, Margherita
AU - Pascutto, Cristiana
AU - Lazzarino, Mario
AU - Cazzola, Mario
AU - Tefferi, Ayalew
PY - 2010/3/4
Y1 - 2010/3/4
N2 - Age older than 65 years, hemoglobin level lower than 100 g/L (10 g/dL), white blood cell count greater than 25 × 109/L, peripheral blood blasts 1% or higher, and constitutional symptoms have been shown to predict poor survival in primary myelofibrosis (PMF) at diagnosis. To investigate whether the acquisition of these factors during follow-up predicts survival, we studied 525 PMF patients regularly followed. All 5 variables had a significant impact on survival when analyzed as time-dependent covariates in a multivariate Cox proportional hazard model and were included in 2 separate models, 1 for all patients (Dynamic International Prognostic Scoring System [DIPSS]) and 1 for patients younger than 65 years (ageadjusted DIPSS). Risk factors were assigned score values based on hazard ratios (HRs). Risk categories were low, intermediate-1, intermediate-2, and high in both models. Survival was estimated by the HR. When shifting to the next risk category, the HR was 4.13 for low risk, 4.61 for intermediate-1, and 2.54 for intermediate-2 according to DIPSS; 3.97 for low risk, 2.84 for intermediate-1, and 1.81 for intermediate-2 according to the age-adjusted DIPSS. The novelty of these models is the prognostic assessment of patients with PMF anytime during their clinical course, which may be useful for treatment decision-making.
AB - Age older than 65 years, hemoglobin level lower than 100 g/L (10 g/dL), white blood cell count greater than 25 × 109/L, peripheral blood blasts 1% or higher, and constitutional symptoms have been shown to predict poor survival in primary myelofibrosis (PMF) at diagnosis. To investigate whether the acquisition of these factors during follow-up predicts survival, we studied 525 PMF patients regularly followed. All 5 variables had a significant impact on survival when analyzed as time-dependent covariates in a multivariate Cox proportional hazard model and were included in 2 separate models, 1 for all patients (Dynamic International Prognostic Scoring System [DIPSS]) and 1 for patients younger than 65 years (ageadjusted DIPSS). Risk factors were assigned score values based on hazard ratios (HRs). Risk categories were low, intermediate-1, intermediate-2, and high in both models. Survival was estimated by the HR. When shifting to the next risk category, the HR was 4.13 for low risk, 4.61 for intermediate-1, and 2.54 for intermediate-2 according to DIPSS; 3.97 for low risk, 2.84 for intermediate-1, and 1.81 for intermediate-2 according to the age-adjusted DIPSS. The novelty of these models is the prognostic assessment of patients with PMF anytime during their clinical course, which may be useful for treatment decision-making.
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U2 - 10.1182/blood-2009-09-245837
DO - 10.1182/blood-2009-09-245837
M3 - Article
C2 - 20008785
AN - SCOPUS:77950352432
SN - 0006-4971
VL - 115
SP - 1703
EP - 1708
JO - Blood
JF - Blood
IS - 9
ER -