A dynamic prognostic model to predict survival in post-polycythemia vera myelofibrosis.

Blood 2008 Apr 10;111(7):3383-7. Epub 2008 Jan 10.

Department of Hematology, Fondazione Istituto di ricovero e cura a carattere scientifico Policlinico San Matteo, University of Pavia, Italy.

Post-polycythemia vera myelofibrosis (post-PV MF) is a late evolution of PV. In 647 patients with PV, we found that leukocytosis leukocyte count>(15x10(9)/L) at diagnosis is a risk factor for the evolution of post-PV MF. In a series of 68 patients who developed post-PV MF, median survival was 5.7 years. Hemoglobin level less than 100 g/L (10 g/dL) at diagnosis of post-PV MF was an independent risk factor for survival. The course of post-PV MF, however, is a dynamic process that implies a progressive worsening of clinical parameters. Using a multivariate Cox proportional hazard regression with time-dependent covariates, we found that a dynamic score based on hemoglobin level less than 100 g/L (10 g/dL), platelet count less than 100x10(9)/L, and leukocyte count more than 30x10(9)/L is useful to predict survival at any time from diagnosis of post-PV MF. The resulting hazard ratio of the score was 4.2 (95% CI: 2.4-7.7; P<.001), meaning a 4.2-fold worsening of survival for each risk factor acquired during follow up. In conclusion, leukocytosis at diagnosis of PV is a risk factor for evolution in post-PV MF. A dynamic score based on hemoglobin level, and platelet and leukocyte count predicts survival at any time from diagnosis of post-PV MF.

Download full-text PDF

Source
http://www.bloodjournal.org/content/111/7/3383.full.pdf
Web Search
http://www.mpnresearchfoundation.org/images/files/Dynamicpro
Web Search
http://www.bloodjournal.org/cgi/doi/10.1182/blood-2007-11-12
Publisher Site
http://dx.doi.org/10.1182/blood-2007-11-121434DOI Listing
April 2008
23 Reads

Publication Analysis

Top Keywords

risk factor
8
vera myelofibrosis
8
hemoglobin level
8
level 100
8
g/l g/dl
8
100 g/l
8
post-polycythemia vera
8
diagnosis post-pv
8
predict survival
8
post-pv
6
clinical parameters
4
worsening clinical
4
progressive worsening
4
implies progressive
4
multivariate cox
4
hazard regression
4
proportional hazard
4
cox proportional
4
process implies
4
parameters multivariate
4

References

(Supplied by CrossRef)
Proposed criteria for the diagnosis of post-polycythemia vera and post-essential thrombocythemia myelofibrosis: a consensus statement from the international working group for myelofibrosis research and treatment.
Barosi et al.
Leukemia
Polycythemia vera in young patients: a study on the long-term risk of thrombosis, myelofibrosis and leukemia.
Passamonti et al.
Haematologica 2003
Myelofibrosis with myeloid metaplasia.
Tefferi et al.
N Engl J Med 2000

Similar Publications