Lancman et al evaluated prognosis in patients in the blast phase of myeloproliferative neoplasms. The authors are from Mount Sinai in New York City and Massachusetts General Hospital.
Patient selection: blast phase of a myeloproliferative neoplasm
Parameters:
(1) type of therapy
(2) transfusion dependence
(3) complications following stem cell transplant (if received)
The best survival was for a patient who received a stem cell transplant with complete response to induction therapy and not transfusion dependent, assuming survival of complications. Lower survival was seen after transplant and incomplete response to induction therapy.
The worst survival was associated with supportive care (median 1.1 months).
Therapy with hypomethylation agents in patients not undergoing transplant had a survival comparable to induction chemotherapy with less toxicity.
Other factors associated with limited survival:
(1) severe complications after stem cell transplant
(2) poor response to induction chemotherapy
(3) transfusion dependence during period of myeloproliferative disease
