Validation and comparison of contemporary prognostic models in primary myelofibrosis

Abstract

BACKGROUND. Survival in primary myelofibrosis (PMF) is predicted by several prognostic scoring systems (PSSs); the most widely recognized is that of Dupriez. Two other PSSs, Cervantes and Mayo, were recently reported as being more useful in younger patients. The current study compares these 3 PSSs among all age groups. METHODS. The Mayo Clinic PMF database was queried to identify a consecutive series of patients in whom pretreatment bone marrow and complete blood count (CBC), obtained within 6 months of diagnosis, were available for review. RESULTS. Among 334 study patients (median age, 57 years), median survival was 70 months. Multivariable analysis of all 6 adverse prognostic factors utilized in the aforementioned PSSs (ie, hemoglobin 9/L, constitutional symptoms, circulating blasts ≥1%, platelet count 9/L, absolute monocyte count ≥1 × 10⁹/L) identified all but platelet count as being significant. The Mayo PSS, which is based on the 4 CBC‐derived parameters (ie, hemoglobin, platelet, leukocyte, and monocyte counts), displayed a better hazard ratio profile compared with the other 2 PSSs in identifying long‐lived patients as well as delineating intermediate‐risk disease category. The latter effect was even more pronounced in patients younger than age 60 years. CONCLUSIONS. The Mayo PSS for survival in PMF is an objective CBC‐derived prognostic model that might be superior in its performance over that of either the Dupriez and Cervantes PSSs. Cancer 2007. © 2007 American Cancer Society.