2014
DOI: 10.1007/s12032-014-0869-8
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Contribution of comorbidities and grade of bone marrow fibrosis to the prognosis of survival in patients with primary myelofibrosis

Abstract: The widely used current International Prognostic Scoring System (IPSS) for primary myelofibrosis (PMF) is based on clinical parameters. The objective of this study was to identify additional prognostic factors at the time of diagnosis, which could have an impact on the future treatment of patients with PMF. We conducted a study of 131 consecutive PMF patients with median follow-up of 44 months. Data on baseline demographics, clinical and laboratory parameters, IPSS, grade of bone marrow fibrosis (MF), as well … Show more

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Cited by 37 publications
(38 citation statements)
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“…Importantly the grade of BMF was an independent risk factor for overall survival when analyzed with IPSS and competing comorbidities. 45 In a study that included 196 patients with PMF, higher grade BMF was an independent predictor of poor survival. 46 Moreover, higher grade BMF can further refine the prognosis of PMF patients with low and intermediate risk IPSS.…”
Section: Myelofibrosismentioning
confidence: 99%
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“…Importantly the grade of BMF was an independent risk factor for overall survival when analyzed with IPSS and competing comorbidities. 45 In a study that included 196 patients with PMF, higher grade BMF was an independent predictor of poor survival. 46 Moreover, higher grade BMF can further refine the prognosis of PMF patients with low and intermediate risk IPSS.…”
Section: Myelofibrosismentioning
confidence: 99%
“…In most of these studies, high grade BMF was associated with worse outcome. 45,46 In a retrospective analysis that included 131 patients with PMF, Lekovic et al found that BMF grade >1 was associated with shorter overall survival (median: 51 months) compared to grade ≤1 (median: 147 months). Importantly the grade of BMF was an independent risk factor for overall survival when analyzed with IPSS and competing comorbidities.…”
Section: Myelofibrosismentioning
confidence: 99%
“…In European and Mayo clinic cohorts of PMF patients with ASXL1, EZH2, SRSF2 and IDH mutations, respectively, were associated with reduced survival [52], as did CALR − ASXL1 + mutational status [53]. Survival is adversely affected by the presence of co-morbidities and higher-grade bone marrow fibrosis [54]. In a recently published review article of ruxolitinib therapy, a survival advantage is shown in treated PMF patients [55] as evidenced by recent trial data [56].…”
Section: Pmfmentioning
confidence: 99%
“…Elevation of specific cytokines [57], presence of specific mutations [17–19], bone marrow fibrosis grade [58, 59], splenomegaly [55, 60], and comorbidities [59] all may have prognostic implications in addition to the parameters in established scoring systems. Ruxolitinib has been shown to modify some of these factors, including splenomegaly, symptoms and symptom-related cytokine levels, and cachexia-related weight loss and hypocholesterolemia [23, 24, 61], but in general does not cause rapid or major changes in bone marrow histomorphology and generally has no major effect on mutant allele burden [24, 29••].…”
Section: Ruxolitinib In the Management Of Patients With Mfmentioning
confidence: 99%