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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 (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 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 HighWire 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted November 5, 2007 Accepted January 3, 2008 A dynamic prognostic model to predict survival in post-polycythemia vera myelofibrosis Francesco Passamonti*, Elisa Rumi, Marianna Caramella, Chiara Elena, Luca Arcaini, Emanuela Boveri, Cecilia Del Curto, Daniela Pietra, Laura Vanelli, Paolo Bernasconi, Cristiana Pascutto, Mario Cazzola, Enrica Morra, and Mario Lazzarino Department of Hematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy Department of Hematology, Ospedale Niguarda Ca Granda, Milano, Italy Department of Surgical Pathology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy * Corresponding author; email: f.passamonti{at}smatteo.pv.it. Post-polycythemia vera myelofibrosis (post-PV MF) is a late evolution of PV. Within 647 patients with PV we found that leukocytosis (white blood cell count >15 x109/L) at diagnosis is a risk factor for the evolution in post-PV MF. In a series of 68 patients who developed post-PV MF median survival was 5.7 years. Hemoglobin level <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 <10 g/dL, platelet count <100 x109/L, and white blood cell count >30 x109/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, platelet and white blood cell count predicts survival at any time from diagnosis of post-PV MF. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. M. Vannucchi, P. Guglielmelli, and A. Tefferi Advances in Understanding and Management of Myeloproliferative Neoplasms CA Cancer J Clin, May 1, 2009; 59(3): 171 - 191. [Abstract] [Full Text] [PDF] F. Passamonti and E. Rumi Clinical relevance of JAK2 (V617F) mutant allele burden Haematologica, January 1, 2009; 94(1): 7 - 10. [Full Text] [PDF] F. Passamonti, E. Rumi, L. Arcaini, E. Boveri, C. Elena, D. Pietra, S. Boggi, C. Astori, P. Bernasconi, M. Varettoni, et al. Prognostic factors for thrombosis, myelofibrosis, and leukemia in essential thrombocythemia: a study of 605 patients Haematologica, November 1, 2008; 93(11): 1645 - 1651. [Abstract] [Full Text] [PDF]

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