Cervantes et al were able to separate patients with idiopathic myelofibrosis into good and poor prognostic groups based on 4 risk factors. The study was done at the Hospital Clinic in Barcelona, Spain.
Parameters:
(1) age
(2) constitutional symptoms
(3) hemoglobin
(4) circulating blasts
|
Parameter |
Finding |
Points |
|
age |
<= 64 |
0 |
|
|
> 64 |
1 |
|
constitutional symptoms |
absent |
0 |
|
|
present |
1 |
|
hemoglobin |
>= 10 g/dL |
0 |
|
|
< 10 g/dL |
1 |
|
circulating blasts |
absent |
0 |
|
|
present |
1 |
where:
• Constitutional symptoms = fever, night sweats, and/or weight loss (B symptoms for malignant lymphoma)
score =
= SUM(points for all 4 factors)
Interpretation:
• minimum score: 0
• maximum score: 4
• Survival decreases as the number of risk factors increase.
|
Score |
Median Survival in Months |
95% Confidence Interval |
|
0 |
130.1 months |
76.0 - (uncertain) |
|
1 |
68.7 months |
47.4 - 98.9 |
|
2 |
21.5 months |
13.3 - 32.4 |
|
3 |
10.0 months |
6.0 - 20.1 |
Since the 95% confidence intervals for patients with 0-1 and 2-3 risk factors overlap, they combined these groups into low and high risk groups.
|
Score |
Risk Group |
Median Survival in Months |
95% Confidence Interval |
|
0 or 1 |
low |
98.8 months |
68.7 - 127.6 |
|
2, 3 or 4 |
high |
20.6 months |
10 - 28.2 |
While Visani et al (1990) and Dupriez et al (1996) tried to divide patients into 3 prognostic groups, Cervantes feels that the survival curves of the intermediate and high risk groups overlap and that these should be combined into a single poor survival group.
Specialty: Hematology Oncology
ICD-10: ,
