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A Prognostic Model for Post-Splenectomy Survival

Am J Hematol; ePub 2017 Aug 7; Tefferi, et al

Considering risk factors can help identify people with myelofibrosis who are the best candidates for splenectomy, according to a study involving 120 individuals (age median 66 years). Karyotype was abnormal in 60% and driver mutational status was JAK2 75%, CALR 15%, MPL 4%, and triple-negative 6%. Investigators looked at how risk factors impacted post-splenectomy survival. Among the results:

  • At median follow-up of 1.3 years, nearly 80% died, and one-fourth experienced leukemic transformation.
  • Median post-splenectomy survival was 1.5 years.
  • Patients aged >65 years, as well as those with transfusion need, leukocyte count >25 x 10(9)/L, and circulating blasts ≥5% experienced worse survival.
  • Median survival was 4 months in patients with 3 to 4 risk factors.
  • Survival was 1.3 years in those with 2 risk factors, and nearly 3 years in those with 0 or 1 risk factor.
  • Driver mutational status and leukemic transformation did not impact post-splenectomy survival.
  • Very high-risk karyotype predicted leukemia-free survival.


Tefferi A, Mudireddy M, Gangat N, et al. Risk factors and a prognostic model for post-splenectomy survival in myelofibrosis. [Published online ahead of print August 7, 2017]. Am J Hematol. doi:10.1002/ajh.24881.