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Prognostic risk models for transplant decision-making in myelofibrosis

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Hernandez-Boluda, JC
  • Pereira, A
  • Correa, JG
  • Alvarez-Larran, A
  • Ferrer-Marin, F
  • Raya, JM
  • Martinez-Lopez, J
  • Velez, P
  • Perez-Encinas, M
  • Estrada, N
  • Garcia-Gutierrez, V
  • Fox, ML
  • Payer, A
  • Kerguelen, A
  • Cuevas, B
  • Duran, MA
  • Ramirez, MJ
  • Gomez-Casares, MT
  • Mata-Vazquez, MI
  • Gomez, M
  • Cervantes, F

Grupos

Abstract

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.

Datos de la publicación

ISSN/ISSNe:
0939-5555, 1432-0584

ANNALS OF HEMATOLOGY  SPRINGER

Tipo:
Article
Páginas:
813-820
PubMed:
29396714
Factor de Impacto:
1,085 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 9

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Keywords

  • Myelofibrosis; Risk factors; Prognostic models; Survival; Transplantation

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