A dynamic prognostic model to predict survival in primary myelofibrosis: A study by the IWG-MRT (International Working Group for Myeloproliferative Neoplasms Research and Treatment)

Francesco Passamonti, Francisco Cervantes, Alessandro Maria Vannucchi, Enrica Morra, Elisa Rumi, Arturo Pereira, Paola Guglielmelli, Ester Pungolino, Marianna Caramella, Margherita Maffioli, Cristiana Pascutto, Mario Lazzarino, Mario Cazzola, Ayalew Tefferi

Research output: Contribution to journalArticle

511 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1703-1708
Number of pages6
JournalBlood
Volume115
Issue number9
DOIs
StatePublished - Mar 4 2010

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Passamonti, F., Cervantes, F., Vannucchi, A. M., Morra, E., Rumi, E., Pereira, A., Guglielmelli, P., Pungolino, E., Caramella, M., Maffioli, M., Pascutto, C., Lazzarino, M., Cazzola, M., & Tefferi, A. (2010). A dynamic prognostic model to predict survival in primary myelofibrosis: A study by the IWG-MRT (International Working Group for Myeloproliferative Neoplasms Research and Treatment). Blood, 115(9), 1703-1708. https://doi.org/10.1182/blood-2009-09-245837