Details

Autor(en) / Beteiligte

• Hernández-Boluda, Juan-Carlos
• Pereira, Arturo
• Correa, Juan-Gonzalo
• Alvarez-Larrán, Alberto
• Ferrer-Marín, Francisca
• Raya, José-María
• Martínez-López, Joaquín
• Velez, Patricia
• Pérez-Encinas, Manuel
• Estrada, Natalia
• García-Gutiérrez, Valentín
• Fox, María-Laura
• Payer, Angel
• Kerguelen, Ana
• Cuevas, Beatriz
• Durán, María-Antonia
• Ramírez, María-José
• Gómez-Casares, María-Teresa
• Mata-Vázquez, María-Isabel
• Mora, Elvira
• Gómez, Montse
• Cervantes, Francisco

Titel

Prognostic risk models for transplant decision-making in myelofibrosis

Ist Teil von

• Annals of hematology, 2018-05, Vol.97 (5), p.813-820

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Prognostic models are widely used in clinical practice for transplant decision-making in myelofibrosis (MF). We have compared the performance of the International Prognostic Scoring System (IPSS), dynamic IPSS (DIPSS), and DIPSS-plus in a series of 544 patients with primary or secondary MF aged ≤ 70 years at the time of diagnosis. The median projected survival of the overall series was 9.46 years (95% confidence interval 7.44–10.59). Median survival for the highest risk groups was less than 4 years in the three prognostic models. By contrast, the projected survival for patients in the intermediate-2 categories by the IPSS, DIPSS, and DIPSS-plus was 6.6, 5.6, and 6.5 years, respectively. The number of patients in the intermediate-2 and high-risk categories was smaller in the DIPSS than in the IPSS or the DIPSS-plus. The IPSS and DIPSS-plus were the best models to discriminate between the intermediate-1 and intermediate-2 risk categories, which is a critical cut-off point for patient selection to transplant. Among patients assigned at diagnosis to the intermediate-2 or high-risk groups by the IPSS, DIPSS, and DIPSS-plus, only 17, 21, and 20%, respectively, were subsequently transplanted. In conclusion, in our contemporary series of younger MF patients only the highest risk categories of the current prognostication systems have a median survival below the 5-year threshold recommended for considering transplantation. Patient selection for transplantation can significantly differ depending on which prognostication model is used for disease risk stratification.