Huang et al identified risk factors associated with leukemic transformation in a patient with primary myelofibrosis. This can help identify patients who may benefit from more aggressive management. The authors are from the Mayo Clinic.
Parameters:
(1) platelet count at the time of diagnosis
(2) percent blasts in the peripheral blood at the time of diagnosis
Parameter
Finding
Points
platelet count
>= 100,000 per µL
0
< 100,000 per µL
1
percent blasts
< 3%
0
>= 3%
1
number of risk factors =
= SUM(points for the 2 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 2
• The higher the number of risk factors the greater the risk for leukemic transformation.
Number of Risk Factors
Percent with Leukemia at 5 Years
0
15%
1 or 2
58% (4 fold greater)
Additional risk factors for a leukemia transformation:
(1) history of therapy with erythropoietin-stimulating agent
(2) history of therapy with danazol (an anabolic steroid with androgenic and antigonadotropic effects)
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