Hemoglobin levels and circulating blasts are two easily evaluable diagnostic parameters highly predictive of leukemic transformation in primary myelofibrosis.
To predict leukemic transformation (LT), we evaluated easily detectable diagnostic parameters in 338 patients with primary myelofibrosis (PMF) followed in the Latium region (Italy) between 1981 and 2010. Forty patients (11.8%) progressed to leukemia, with a resulting 10-year leukemia-free survival (LFS) rates of 72%. Hb (<10g/dL), and circulating blasts (≥1%) were the only two independent prognostic for LT at the multivariate analysis. Two hundred-fifty patients with both the two parameters available were grouped as follows: low risk (none or one factor)=216 patients; high risk (both factors)=31 patients. The median LFS times were 269 and 45 months for the low and high-risk groups, respectively (P<.0001). The LT predictive power of these two parameters was confirmed in an external series of 270 PMF patients from Tuscany, in whom the median LFS was not reached and 61 months for the low and high risk groups, respectively (P<.0001). These results establish anemia and circulating blasts, two easily and universally available parameters, as strong predictors of LT in PMF and may help to improve prognostic stratification of these patients particularly in countries with low resources where more sophisticated molecular testing is unavailable.
['Rago|Angela|A|', 'Latagliata|Roberto|R|', 'Montanaro|Marco|M|', 'Montefusco|Enrico|E|', 'Andriani|Alessandro|A|', 'Crescenzi|Sabrina Leonetti|SL|', 'Mecarocci|Sergio|S|', 'Spirito|Francesca|F|', 'Spadea|Antonio|A|', 'Recine|Umberto|U|', 'Cicconi|Laura|L|', 'Avvisati|Giuseppe|G|', 'Cedrone|Michele|M|', 'Breccia|Massimo|M|', 'Porrini|Raffaele|R|', 'Villivà|Nicoletta|N|', 'De Gregoris|Cinzia|C|', 'Alimena|Giuliana|G|', "D'Arcangelo|Enzo|E|", 'Guglielmelli|Paola|P|', 'Lo-Coco|Francesco|F|', 'Vannucchi|Alessandro|A|', 'Cimino|Giuseppe|G|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000740:Anemia D001752:Blast Crisis D002471:Cell Transformation, Neoplastic D005260:Female D005500:Follow-Up Studies D006454:Hemoglobins D006801:Humans D008297:Male D008875:Middle Aged D009360:Neoplastic Cells, Circulating D055728:Primary Myelofibrosis D011379:Prognosis D012189:Retrospective Studies D015996:Survival Rate D054928:Validation Studies as Topic
Circulating blasts Primary myelofibrosis Anemia Leukaemic transformation Leukemic transformation risk