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Which Liver Function Test Has Prognostic Relevance?

Blood Cancer J; ePub 2017 Apr 21; Barraco, et al

Increased serum alkaline phosphatase (ALP) is relatively common in primary myelofibrosis (PMF), but the incidence of elevated serum aspartate aminotransferase (AST) is not, according to a study involving nearly 400 individuals.

Investigators performed cytogenetic and mutational analyses on participants with PMF. They checked liver function via ALP and AST, and screened for relevant mutations using targeted next-generation sequencing. Among the results:

  • After a median follow-up of 3 years, 60% of patients died, and 9% experienced leukemic transformations.
  • Increased ALP and AST were linked with inferior survival.
  • Increased serum ALP or AST did not affect leukemia-free survival.
  • The magnitude of the abnormalities was mostly grade 1 for AST, but grade 2 for ALP in ~7 of the patients.
  • There were significant links with marked leukocytosis for both ALP and AST.


Barraco D, Mudireddy M, Shah S, et al. Liver function test abnormalities and their clinical relevance in primary myelofibrosis. [Published online ahead of print April 21, 2017]. Blood Cancer J. doi:10.1038/bcj.2017.34.