Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Predicting Survival in Patients with Post-PV/ET

Leukemia; ePub 2017 Aug 18; Tefferi, Saeed, et al

The 8 risk variables used in 3 scoring systems have predictive value in patients with either post-polycythemia vera (post-PV MF) or post-essential thrombocythemia myelofibrosis (post-ET MF), according to a study involving 125 individuals. Participants had primary MF (PMF), prefibrotic PMF, post-ET MF, or post-PV MF. Investigators looked at whether the 8 variables used in the International Prognostic Scoring System (IPSS), dynamic IPSS (DIPSS), and DIPSS-plus could predict shortened survival in post-PV/ET MF. Among the results:

  • At a median follow-up of 3 years after fibrotic progression began, nearly 70% died.
  • 5 risk variables used in IPSS or DIPSS predicted shortened survival for all but constitutional symptoms.
  • Patients with circulating blasts ≥1%, were more than twice as likely to experience shortened survival.
  • Those with hemoglobin 25 x 109/L were nearly twice as likely to experience such.
  • The 8 risk variables used in DIPSS-plus predicted all except constitutional symptoms and leukocyte count >25 x 109/L with borderline significance.


Tefferi A, Saeed L, Hanson CA, Ketterling R, Pardanani A, Gangat N. Application of current prognostic models for primary myelofibrosis in the setting of post polycythemia vera or post-essential thrombocythemia myelofibrosis. [Published online ahead of print August 18, 2017]. Leukemia. doi:10.1038/leu.2017.268.