Prognostic impact of bone marrow fibrosis in polycythemia vera: Validation of the IWG-MRT study and additional observations

D. Barraco, S. Cerquozzi, C. A. Hanson, R. P. Ketterling, A. Pardanani, N. Gangat, A. Tefferi

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

In 2012, the International Working Group for Myeloproliferative Neoplasms (MPN) Research and Treatment (IWG-MRT) reported an associations between mild bone marrow (BM) fibrosis (≥grade 1) in polycythemia vera (PV) and a lower incidence of thrombosis during the clinical course and a higher risk of fibrotic progression. The objective in the current study of 262 patients with PV was to validate these observations and also identify other risk factors for myelofibrosis-free survival (MFFS). About 127 (48%) patients displayed ≥grade 1 reticulin fibrosis at the time of diagnosis; presenting clinical and laboratory features were not significantly different between patients with or without BM fibrosis. In univariate analysis, BM fibrosis had no significant impact on overall, leukemia-free or thrombosis-free survival, whereas a significant association was noted for MFFS (P = 0.009, hazard ratio 2.9; 95% confidence interval 1.32-6.78); other risk factors for MFFS included leukocytosis ≥15 × 109/l, presence of palpable splenomegaly and abnormal karyotype. During multivariable analysis, leukocytosis ≥15 × 109/l, palpable splenomegaly and ≥grade 1 BM reticulin fibrosis remained significant. The current study validates the previously observed association between ≥ grade 1 BM reticulin fibrosis in PV and subsequent fibrotic progression, and identifies leukocytosis and palpable splenomegaly as additional risk factors for fibrotic progression; additional studies are required to clarify the impact of BM fibrosis on thrombosis and that of abnormal karyotype on MFFS.

Original languageEnglish (US)
Article numbere538
JournalBlood cancer journal
Volume7
Issue number3
DOIs
StatePublished - Mar 10 2017

ASJC Scopus subject areas

  • Hematology
  • Oncology

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