Prognostic model to identify patients with myelofibrosis at the highest risk of transformation to acute myeloid Leukemia

Alfonso Quintás-Cardama, Hagop Kantarjian, Sherry Pierce, Jorge Cortes, Srdan Verstovsek

Research output: Contribution to journalArticle

16 Scopus citations


Background: Some patients with myelofibrosis (MF) progress to acute myeloid leukemia (AML). Current prognostic tools were not devised to assess risk of AML transformation. Methods: Multivariate analysis in 649 patients followed for a median of 19 months (range, 1-180 months). Results: We identified age > 60 (P =.004; hazard ratio [HR], 1.63), platelets <100 × 109/L (P <.001; HR, 1.62), bone marrow blast > 10% (P =.002; HR, 2.18), high-risk karyotype (P <.001; HR, 2.44), transfusion dependency (P <.001; HR, 2.64), performance status > 1 (P =.003; HR, 1.47), lactate dehydrogenase > 2000 U/L (P <.001; HR, 1.62), previous hydroxyurea (P <.001; HR, 1.69), and male sex (P =.005; HR, 1.41) as independent poor prognostic factors for survival. Using the same baseline variables we identified bone marrow blasts >10% and worst karyotype as independent risk factors for AML transformation. Patients with 1 or both of these risk factors (n = 80; 12%) had a median survival of 10 months and a 1-year AML transformation rate of 13% (2% if none of those factors, P =.001). Conclusion: We have identified risk factors that predict high risk of transformation from MF to AML.

Original languageEnglish (US)
Pages (from-to)315-318.e2
JournalClinical Lymphoma, Myeloma and Leukemia
Issue number3
StatePublished - Jun 2013
Externally publishedYes



  • Acute myeloid leukemia
  • Death
  • Multivariate analysis
  • Myelofibrosis
  • Prognostic model
  • Progression
  • Transformation

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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