Premium
Validation and comparison of contemporary prognostic models in primary myelofibrosis
Author(s) -
Tefferi Ayalew,
Huang Jocelin,
Schwager Susan,
Li ChinYang,
Wu Wenting,
Pardanani Animesh,
Mesa Ruben A.
Publication year - 2007
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22630
Subject(s) - medicine , myelofibrosis , hazard ratio , complete blood count , gastroenterology , bone marrow , proportional hazards model , platelet , surgery , confidence interval
BACKGROUND. Survival in primary myelofibrosis (PMF) is predicted by several prognostic scoring systems (PSSs); the most widely recognized is that of Dupriez . Two other PSSs, Cervantes and Mayo , were recently reported as being more useful in younger patients. The current study compares these 3 PSSs among all age groups. METHODS. The Mayo Clinic PMF database was queried to identify a consecutive series of patients in whom pretreatment bone marrow and complete blood count (CBC), obtained within 6 months of diagnosis, were available for review. RESULTS. Among 334 study patients (median age, 57 years), median survival was 70 months. Multivariable analysis of all 6 adverse prognostic factors utilized in the aforementioned PSSs (ie, hemoglobin <10 g/dL, leukocyte count <4 or >30 × 10 9 /L, constitutional symptoms, circulating blasts ≥1%, platelet count <100 × 10 9 /L, absolute monocyte count ≥1 × 10 9 /L) identified all but platelet count as being significant. The Mayo PSS, which is based on the 4 CBC‐derived parameters (ie, hemoglobin, platelet, leukocyte, and monocyte counts), displayed a better hazard ratio profile compared with the other 2 PSSs in identifying long‐lived patients as well as delineating intermediate‐risk disease category. The latter effect was even more pronounced in patients younger than age 60 years. CONCLUSIONS. The Mayo PSS for survival in PMF is an objective CBC‐derived prognostic model that might be superior in its performance over that of either the Dupriez and Cervantes PSSs. Cancer 2007. © 2007 American Cancer Society.