Premium
Age and platelet count are IPSS‐independent prognostic factors in young patients with primary myelofibrosis and complement IPSS in predicting very long or very short survival
Author(s) -
Patnaik Mrinal M.,
Caramazza Domenica,
Gangat Naseema,
Hanson Curtis A.,
Pardanani Animesh,
Tefferi Ayalew
Publication year - 2010
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2009.01373.x
Subject(s) - medicine , myelofibrosis , international prognostic scoring system , survival analysis , young adult , myelodysplastic syndromes , bone marrow
Abstract Objectives: The current study was designed to identify International Prognostic Scoring System (IPSS)‐independent prognostic factors in young patients with primary myelofibrosis (PMF). The study also examined the overall risk profile of long‐term (>15 yr) and short‐term (<5 yr) survivors. Methods: Study patients were selected from the Mayo Clinic database for PMF, and study eligibility included age <60 yr, minimum follow‐up of 5 yr and availability of IPSS‐relevant variables at time of diagnosis. Results: A total of 148 consecutive patients met the above‐stipulated criteria. To date, 89 (60%) patients have died; 48 (32%) died within 5 yr of their diagnosis (short‐term survivors). Median follow‐up of patients who are alive was 9 yr (range 5–28) with a >15‐yr survival documented in 16 patients (long‐term survivors). Multivariable analysis identified unfavorable IPSS category (intermediate‐2/high risk), age >50 yr and platelet count <100 × 10 9 /L as independent predictors of inferior survival ( P < 0.01). Median survival in the absence of all three risk factors was approximately 18 yr and was shortened to 7 and 1.6 yr in the presence of 1 or ≥2 risk factors, respectively ( P < 0.01). Among long‐term survivors, 69% were age ≤50 yr, 100% had favorable IPSS profile and 100% displayed platelet count ≥100 × 10 9 /L; the corresponding figures for short‐term survivors were 29%, 50% and 65% ( P < 0.01). Conclusions: Age and platelet count are IPSS‐independent predictors of survival in young patients with PMF, and they complement the IPSS in identifying patients with very long or very short survival.