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Red blood cell transfusion need at diagnosis adversely affects survival in primary myelofibrosis—increased serum ferritin or transfusion load does not
Author(s) -
Tefferi Ayalew,
Mesa Ruben A.,
Pardanani Animesh,
Hussein Kebede,
Schwager Susan,
Hanson Curtis A.,
Steensma David P.
Publication year - 2009
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.21391
Subject(s) - myelofibrosis , medicine , ferritin , gastroenterology , serum ferritin , blood transfusion , red blood cell , anemia , transfusion therapy , immunology , surgery , bone marrow
Abstract Serum ferritin level at diagnosis was available in 185 patients with primary myelofibrosis (PMF); twenty‐two (12%) patients had serum ferritin >1,000 ng/mL and 32 (17%) were red blood cell (RBC) transfusion‐dependent. As expected, RBC transfusion need and increased serum ferritin displayed strong correlation ( P < 0.0001); in addition, the latter but not the former correlated with advanced age ( P < 0.0001). During median follow‐up of 28 months (range 0.5–231), peak serum ferritin levels exceeded 1,000 ng/mL in 41 (22%) patients. On multivariable analysis that included age as a covariate, RBC transfusion need at diagnosis ( P < 0.0001), but not increased serum ferritin or transfusion load, predicted shortened survival. The prognostic relevance of RBC transfusion need was independent of the International Prognostic Scoring System and was also illustrated for leukemia‐free survival ( P = 0.003). In PMF, the presence of a more severe erythropoietic defect, and not iron overload, has additional adverse prognostic value. Am. J. Hematol., 2009. © 2009 Wiley‐Liss, Inc.