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Prognostic Score System for Patients with PMF

J Clin Oncol; ePub 2017 Dec 9; Gugliemelli, et al

Integrated clinical and genetic prognostic models with or without cytogenetic information provide an additional way to stratify risk for transplantation-age patients with primary myelofibrosis (PMF) and assimilate prognostically relevant clinical, cytogenetic, and mutation data, researchers concluded after conducting a study involving >800 individuals. Participants were ≤70 years of age and had PMF. Investigators looked at variables that predicted overall survival, and developed prognostic models both with and without cytogenic information. Among the results:

  • Hemoglobin <100 g/L, leukocytes >25 × 109/L, platelets <100 × 109/L, circulating blasts ≥2%, bone marrow fibrosis grade ≥2, constitutional symptoms, absence of CALR type-1 mutation, presence of high-molecular risk mutation, and presence of ≥2 or more high-molecular risk mutations negatively impacted overall survival.
  • The model without cytogenic information revealed low-, intermediate-, and high-risk categories; overall survival rates were 95%, 70%, and 29%, respectively.
  • The model with cytogenic information revealed low-, intermediate-, high, and very-high risk categories; overall survival rates were 91%, 66%, 42%, and 7%, respectively.
  • Both models remained effective after including older patients.

Citation:

Gugliemelli P, Lasho T, Rotunno G, et al. MIPSS70: Mutation-enhanced international prognostic score system for transplantation-age patients with primary myelofibrosis. [Published online ahead of print December 9, 2017]. J Clin Oncol. doi:10.1200/JCO.2017.76.4886.

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