TY - JOUR
T1 - Blood tests may predict early primary myelofibrosis in patients presenting with essential thrombocythemia
AU - Carobbio, Alessandra
AU - Finazzi, Guido
AU - Thiele, Juergen
AU - Kvasnicka, Hans Michael
AU - Passamonti, Francesco
AU - Rumi, Elisa
AU - Ruggeri, Marco
AU - Rodeghiero, Francesco
AU - Luigia Randi, Maria
AU - Bertozzi, Irene
AU - Vannucchi, Alessandro M.
AU - Antonioli, Elisabetta
AU - Gisslinger, Heinz
AU - Buxhofer-Ausch, Veronika
AU - Gangat, Naseema
AU - Rambaldi, Alessandro
AU - Tefferi, Ayalew
AU - Barbui, Tiziano
PY - 2012/2
Y1 - 2012/2
N2 - According to World Health Organization (WHO)-defined criteria, patients presenting clinically as essential thrombocythemia (ET) may show early primary myelofibrosis (PMF) with accompanying thrombocythemia. Previous clinicopathological studies revealed that laboratory parameters like gender-matched hemoglobin (Hb), white blood cell (WBC) count, and particularly lactate dehydrogenase (LDH) values are significantly different in PMF. By strictly applying the WHO criteria, our investigation was aimed to study sensitivity and specificity of these features in an exploratory cohort of 536 patients and to validate the results on an independently recruited series of 321 strictly corresponding patients. The discriminatory power of these parameters (Hb, WBC, and LDH) was tested by plotting their receiver operating characteristic curves. The best performance was found for LDH (areas under the curve, AUC = 0.7059). WBC and Hb had superimposable curves, with AUC of 0.6279 and 0.6257, respectively. A diagnostic algorithm was generated by applying these parameters in a stepwise fashion. Nearly half of the patients could be correctly allocated to WHO-defined ET or early PMF in both cohorts investigated. It is important to note that this result does not substitute bone marrow morphology with hematological parameters, however, in clinical practice may alert physicians to get more suspicious of early PMF in a patient presumably presenting with ET.
AB - According to World Health Organization (WHO)-defined criteria, patients presenting clinically as essential thrombocythemia (ET) may show early primary myelofibrosis (PMF) with accompanying thrombocythemia. Previous clinicopathological studies revealed that laboratory parameters like gender-matched hemoglobin (Hb), white blood cell (WBC) count, and particularly lactate dehydrogenase (LDH) values are significantly different in PMF. By strictly applying the WHO criteria, our investigation was aimed to study sensitivity and specificity of these features in an exploratory cohort of 536 patients and to validate the results on an independently recruited series of 321 strictly corresponding patients. The discriminatory power of these parameters (Hb, WBC, and LDH) was tested by plotting their receiver operating characteristic curves. The best performance was found for LDH (areas under the curve, AUC = 0.7059). WBC and Hb had superimposable curves, with AUC of 0.6279 and 0.6257, respectively. A diagnostic algorithm was generated by applying these parameters in a stepwise fashion. Nearly half of the patients could be correctly allocated to WHO-defined ET or early PMF in both cohorts investigated. It is important to note that this result does not substitute bone marrow morphology with hematological parameters, however, in clinical practice may alert physicians to get more suspicious of early PMF in a patient presumably presenting with ET.
UR - http://www.scopus.com/inward/record.url?scp=84855932927&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855932927&partnerID=8YFLogxK
U2 - 10.1002/ajh.22241
DO - 10.1002/ajh.22241
M3 - Letter
C2 - 22237692
AN - SCOPUS:84855932927
SN - 0361-8609
VL - 87
SP - 203
EP - 204
JO - American journal of hematology
JF - American journal of hematology
IS - 2
ER -