BACKGROUND: Some patients with myelofibrosis (MF) progress to acute myeloid leukemia (AML). Current prognostic tools were not devised to assess risk of AML transformation. METHODS: Multivariate analysis in 649 patients followed for a median of 19 months (range, 1-180 months). RESULTS: We identified age > 60 (P = .004; hazard ratio [HR], 1.63), platelets <100 × 10(9)/L (P < .001; HR, 1.62), bone marrow blast > 10% (P = .002; HR, 2.18), high-risk karyotype (P < .001; HR, 2.44), transfusion dependency (P < .001; HR, 2.64), performance status > 1 (P = .003; HR, 1.47), lactate dehydrogenase > 2000 U/L (P < .001; HR, 1.62), previous hydroxyurea (P < .001; HR, 1.69), and male sex (P = .005; HR, 1.41) as independent poor prognostic factors for survival. Using the same baseline variables we identified bone marrow blasts >10% and worst karyotype as independent risk factors for AML transformation. Patients with 1 or both of these risk factors (n = 80; 12%) had a median survival of 10 months and a 1-year AML transformation rate of 13% (2% if none of those factors, P = .001). CONCLUSION: We have identified risk factors that predict high risk of transformation from MF to AML.
BACKGROUND: Some patients with myelofibrosis (MF) progress to acute myeloid leukemia (AML). Current prognostic tools were not devised to assess risk of AML transformation. METHODS: Multivariate analysis in 649 patients followed for a median of 19 months (range, 1-180 months). RESULTS: We identified age > 60 (P = .004; hazard ratio [HR], 1.63), platelets <100 × 10(9)/L (P < .001; HR, 1.62), bone marrow blast > 10% (P = .002; HR, 2.18), high-risk karyotype (P < .001; HR, 2.44), transfusion dependency (P < .001; HR, 2.64), performance status > 1 (P = .003; HR, 1.47), lactate dehydrogenase > 2000 U/L (P < .001; HR, 1.62), previous hydroxyurea (P < .001; HR, 1.69), and male sex (P = .005; HR, 1.41) as independent poor prognostic factors for survival. Using the same baseline variables we identified bone marrow blasts >10% and worst karyotype as independent risk factors for AML transformation. Patients with 1 or both of these risk factors (n = 80; 12%) had a median survival of 10 months and a 1-year AML transformation rate of 13% (2% if none of those factors, P = .001). CONCLUSION: We have identified risk factors that predict high risk of transformation from MF to AML.
Authors: Ruben A Mesa; Chin-Yang Li; Rhett P Ketterling; Georgene S Schroeder; Ryan A Knudson; Ayalew Tefferi Journal: Blood Date: 2004-09-23 Impact factor: 22.113
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Authors: Rangit R Vallapureddy; Mythri Mudireddy; Domenico Penna; Terra L Lasho; Christy M Finke; Curtis A Hanson; Rhett P Ketterling; Kebede H Begna; Naseema Gangat; Animesh Pardanani; Ayalew Tefferi Journal: Blood Cancer J Date: 2019-01-25 Impact factor: 11.037