Tefferi et al reported a model for postsplenectomy survival for a patient with myelofbrosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Mayo Clinic.
Patient selection: myelofibrosis
Outcome: postsplenectomy survival
Parameters:
(1) age in years
(2) need for red blood cell transfusion
(3) WBC count in 10^9/L
(4) circulating blasts in percent
Parameter
Finding
Points
age in years
<= 65 years
0
> 65 years
1
need for transfusion
no
0
yes
1
WBC count
<= 25 * 10^9/L
0
> 25 * 10^9/L
1
circulating blasts
< 5%
0
>= 5%
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the worse the overall survival.
Score
Risk Group
Median Survival
0 or 1
low
0.3 years
2
intermediate
1.3 years
3 or 4
high
2.9 years
Leukemia-free survival was negatively affected by the presence of very high-risk karyotype.
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