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Blood, 1 April 2008, Vol. 111, No. 7, pp. 3383-3387. Prepublished online as a Blood First Edition Paper on January 10, 2008; DOI 10.1182/blood-2007-11-121434. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-11-121434v1 111/7/3383    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Passamonti, F. Articles by Lazzarino, M. Search for Related Content PubMed PubMed Citation Articles by Passamonti, F. Articles by Lazzarino, M. Related Collections Neoplasia Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS A dynamic prognostic model to predict survival in post–polycythemia vera myelofibrosis Francesco Passamonti1, Elisa Rumi1, Marianna Caramella2, Chiara Elena1, Luca Arcaini1, Emanuela Boveri3, Cecilia Del Curto1, Daniela Pietra1, Laura Vanelli1, Paolo Bernasconi1, Cristiana Pascutto1, Mario Cazzola1, Enrica Morra2, and Mario Lazzarino1 1 Department of Hematology, Fondazione Istituto di ricovero e cura a carattere scientifico (IRCCS) Policlinico San Matteo, University of Pavia, Pavia; 2 Department of Hematology, Ospedale Niguarda Ca' Granda, Milan; and 3 Department of Surgical Pathology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, University of Pavia, Pavia, Italy Post–polycythemia vera myelofibrosis (post-PV MF) is a late evolution of PV. In 647 patients with PV, we found that leukocytosis leukocyte count > (15 x 109/L) at diagnosis is a risk factor for the evolution of post-PV MF. In a series of 68 patients who developed post-PV MF, median survival was 5.7 years. Hemoglobin level less than 100 g/L (10 g/dL) at diagnosis of post-PV MF was an independent risk factor for survival. The course of post-PV MF, however, is a dynamic process that implies a progressive worsening of clinical parameters. Using a multivariate Cox proportional hazard regression with time-dependent covariates, we found that a dynamic score based on hemoglobin level less than 100 g/L (10 g/dL), platelet count less than 100 x 109/L, and leukocyte count more than 30 x 109/L is useful to predict survival at any time from diagnosis of post-PV MF. The resulting hazard ratio of the score was 4.2 (95% CI: 2.4-7.7; P < .001), meaning a 4.2-fold worsening of survival for each risk factor acquired during follow up. In conclusion, leukocytosis at diagnosis of PV is a risk factor for evolution in post-PV MF. A dynamic score based on hemoglobin level, and platelet and leukocyte count predicts survival at any time from diagnosis of post-PV MF. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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