Tam et al identified findings in a patient with myelofibrosis that are associated with death within 12 months. These patients are considered to be in an accelerated phase (AP) that may justify more aggressive management. The authors are from the M.D. Anderson Cancer Center in Houston and St. Cincent's Hospital in Melbourne.
Patient selection: a patient with myelofibrosis who is not in blast phase (blast phase is a persistent blast count >= 20%). Patients had primary myelofibrosis, myelofibrosis after polycythemia vera and myelofibrosis after essential thrombocythemia.
Parameters:
(1) platelet count
(2) percent blasts in peripheral blood or bone marrow
(3) chromosome 17 aberrations
Parameter
Finding
Points
platelet count
>= 50,000 per µL
0
< 50,000 per µL due to therapy
0
< 50,000 per µL not due to therapy
1
percent blasts
< 10%
0
>= 10%
1
chromosome 17 abnormalities
absent
0
present
1
number of accelerated phase criteria present =
= SUM(points for all 3 parameters)
Interpretatation:
• minimum number of criteria: 0
• maximum number of criteria: 3
• The presence of any one of the criteria was associated with death within 12 months with the shortest survival associated with chromosome 17 abnormalities (5 months).
• The criteria work at an time in the disease course.
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