Dynamic model for predicting death within 12 months in patients with primary or post-polycythemia vera/essential thrombocythemia myelofibrosis

Constantine S. Tam, Hagop Kantarjian, Jorge Cortes, Alice Lynn, Sherry Pierce, Lingsha Zhou, Michael J. Keating, Deborah A. Thomas, Srdan Verstovsek

Research output: Contribution to journalArticle

Abstract

Purpose: Current prognostic tools in myelofibrosis (MF) fail to identify patients at the highest risk of death and are limited by their applicability only to the time of diagnosis. We aimed to define an accelerated phase (AP) in MF by characterizing disease features that can identify patients with median overall survival of ≤ 12 months at any time in the disease course. Patients and Methods: Baseline characteristics of 370 consecutive patients with MF from a single center were analyzed to identify features associated with a median overall survival of ≤ 12 months. These putative AP features were then validated by following the course of chronic-phase patients (no AP features at baseline) until the development of one or more AP features and determining their subsequent survival. Results: The following three characteristics were associated with poor survival at baseline and were selected as putative AP features: blasts in blood or bone marrow ≥ 10%, platelets less than 50 X 109/L, and chromosome 17 aberrations (median overall survival, 10, 12, and 5 months, respectively). In the validation phase, chronic-phase patients who developed AP features during follow-up were found to have short subsequent survival times (median overall survival, 12, 15, and 6 months, respectively). AP was a necessary step in the progression to blast phase, with leukemic transformation being exceedingly rare (3% risk at 10 years) in patients who remained persistently in chronic phase. Conclusion: Blood or bone marrow blasts ≥ 10%, platelets less than 50 X 109/L, and chromosome 17 aberrations defined AP in patients with MF. Patients in AP should be candidates for intensive therapeutic interventions.

Original languageEnglish (US)
Pages (from-to)5587-5593
Number of pages7
JournalJournal of Clinical Oncology
Volume27
Issue number33
DOIs
StatePublished - Nov 20 2009
Externally publishedYes

Fingerprint

Essential Thrombocythemia
Polycythemia Vera
Primary Myelofibrosis
Survival
Blast Crisis
Chromosomes, Human, Pair 17
Chromosome Aberrations
Blood Platelets
Bone Marrow

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Dynamic model for predicting death within 12 months in patients with primary or post-polycythemia vera/essential thrombocythemia myelofibrosis. / Tam, Constantine S.; Kantarjian, Hagop; Cortes, Jorge; Lynn, Alice; Pierce, Sherry; Zhou, Lingsha; Keating, Michael J.; Thomas, Deborah A.; Verstovsek, Srdan.

In: Journal of Clinical Oncology, Vol. 27, No. 33, 20.11.2009, p. 5587-5593.

Research output: Contribution to journalArticle

Tam, Constantine S. ; Kantarjian, Hagop ; Cortes, Jorge ; Lynn, Alice ; Pierce, Sherry ; Zhou, Lingsha ; Keating, Michael J. ; Thomas, Deborah A. ; Verstovsek, Srdan. / Dynamic model for predicting death within 12 months in patients with primary or post-polycythemia vera/essential thrombocythemia myelofibrosis. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 33. pp. 5587-5593.
@article{9a7f9c16c34f4f38a473a0bfc5ce45c1,
title = "Dynamic model for predicting death within 12 months in patients with primary or post-polycythemia vera/essential thrombocythemia myelofibrosis",
abstract = "Purpose: Current prognostic tools in myelofibrosis (MF) fail to identify patients at the highest risk of death and are limited by their applicability only to the time of diagnosis. We aimed to define an accelerated phase (AP) in MF by characterizing disease features that can identify patients with median overall survival of ≤ 12 months at any time in the disease course. Patients and Methods: Baseline characteristics of 370 consecutive patients with MF from a single center were analyzed to identify features associated with a median overall survival of ≤ 12 months. These putative AP features were then validated by following the course of chronic-phase patients (no AP features at baseline) until the development of one or more AP features and determining their subsequent survival. Results: The following three characteristics were associated with poor survival at baseline and were selected as putative AP features: blasts in blood or bone marrow ≥ 10{\%}, platelets less than 50 X 109/L, and chromosome 17 aberrations (median overall survival, 10, 12, and 5 months, respectively). In the validation phase, chronic-phase patients who developed AP features during follow-up were found to have short subsequent survival times (median overall survival, 12, 15, and 6 months, respectively). AP was a necessary step in the progression to blast phase, with leukemic transformation being exceedingly rare (3{\%} risk at 10 years) in patients who remained persistently in chronic phase. Conclusion: Blood or bone marrow blasts ≥ 10{\%}, platelets less than 50 X 109/L, and chromosome 17 aberrations defined AP in patients with MF. Patients in AP should be candidates for intensive therapeutic interventions.",
author = "Tam, {Constantine S.} and Hagop Kantarjian and Jorge Cortes and Alice Lynn and Sherry Pierce and Lingsha Zhou and Keating, {Michael J.} and Thomas, {Deborah A.} and Srdan Verstovsek",
year = "2009",
month = "11",
day = "20",
doi = "10.1200/JCO.2009.22.8833",
language = "English (US)",
volume = "27",
pages = "5587--5593",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "33",

}

TY - JOUR

T1 - Dynamic model for predicting death within 12 months in patients with primary or post-polycythemia vera/essential thrombocythemia myelofibrosis

AU - Tam, Constantine S.

AU - Kantarjian, Hagop

AU - Cortes, Jorge

AU - Lynn, Alice

AU - Pierce, Sherry

AU - Zhou, Lingsha

AU - Keating, Michael J.

AU - Thomas, Deborah A.

AU - Verstovsek, Srdan

PY - 2009/11/20

Y1 - 2009/11/20

N2 - Purpose: Current prognostic tools in myelofibrosis (MF) fail to identify patients at the highest risk of death and are limited by their applicability only to the time of diagnosis. We aimed to define an accelerated phase (AP) in MF by characterizing disease features that can identify patients with median overall survival of ≤ 12 months at any time in the disease course. Patients and Methods: Baseline characteristics of 370 consecutive patients with MF from a single center were analyzed to identify features associated with a median overall survival of ≤ 12 months. These putative AP features were then validated by following the course of chronic-phase patients (no AP features at baseline) until the development of one or more AP features and determining their subsequent survival. Results: The following three characteristics were associated with poor survival at baseline and were selected as putative AP features: blasts in blood or bone marrow ≥ 10%, platelets less than 50 X 109/L, and chromosome 17 aberrations (median overall survival, 10, 12, and 5 months, respectively). In the validation phase, chronic-phase patients who developed AP features during follow-up were found to have short subsequent survival times (median overall survival, 12, 15, and 6 months, respectively). AP was a necessary step in the progression to blast phase, with leukemic transformation being exceedingly rare (3% risk at 10 years) in patients who remained persistently in chronic phase. Conclusion: Blood or bone marrow blasts ≥ 10%, platelets less than 50 X 109/L, and chromosome 17 aberrations defined AP in patients with MF. Patients in AP should be candidates for intensive therapeutic interventions.

AB - Purpose: Current prognostic tools in myelofibrosis (MF) fail to identify patients at the highest risk of death and are limited by their applicability only to the time of diagnosis. We aimed to define an accelerated phase (AP) in MF by characterizing disease features that can identify patients with median overall survival of ≤ 12 months at any time in the disease course. Patients and Methods: Baseline characteristics of 370 consecutive patients with MF from a single center were analyzed to identify features associated with a median overall survival of ≤ 12 months. These putative AP features were then validated by following the course of chronic-phase patients (no AP features at baseline) until the development of one or more AP features and determining their subsequent survival. Results: The following three characteristics were associated with poor survival at baseline and were selected as putative AP features: blasts in blood or bone marrow ≥ 10%, platelets less than 50 X 109/L, and chromosome 17 aberrations (median overall survival, 10, 12, and 5 months, respectively). In the validation phase, chronic-phase patients who developed AP features during follow-up were found to have short subsequent survival times (median overall survival, 12, 15, and 6 months, respectively). AP was a necessary step in the progression to blast phase, with leukemic transformation being exceedingly rare (3% risk at 10 years) in patients who remained persistently in chronic phase. Conclusion: Blood or bone marrow blasts ≥ 10%, platelets less than 50 X 109/L, and chromosome 17 aberrations defined AP in patients with MF. Patients in AP should be candidates for intensive therapeutic interventions.

UR - http://www.scopus.com/inward/record.url?scp=73949151305&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73949151305&partnerID=8YFLogxK

U2 - 10.1200/JCO.2009.22.8833

DO - 10.1200/JCO.2009.22.8833

M3 - Article

C2 - 19786661

AN - SCOPUS:73949151305

VL - 27

SP - 5587

EP - 5593

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 33

ER -