The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis

Umberto Gianelli, Claudia Vener, Anna Bossi, Ivan Cortinovis, Alessandra Iurlo, Nicola S. Fracchiolla, Federica Savi, Alessia Moro, Federica Grifoni, Chiara De Philippis, Tommaso Radice, Silvano Bosari, Giorgio Lambertenghi Deliliers, Agostino Cortelezzi

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

We investigated the relationship between the International Prognostic Scoring System of the International Working Group for Myelofibrosis Research and Treatment and the European Consensus on grading of bone marrow fibrosis (MF) in patients with primary myelofibrosis. We compared them in 196 consecutive primary myelofibrosis patients (median follow-up 45.7 months; range 7.4-159). International Prognostic Scoring System classified 42 cases as low risk, 73 as intermediate risk-1, 69 as intermediate risk-2, and 12 as high risk; European Consensus on grading of bone marrow fibrosis classified 83 cases as MF-0, 58 as MF-1, 41 as MF-2, and 14 as MF-3. By the time of the analysis, 30 patients (15.3%) had died. Overall median survival was 3.8 years (95% confidence interval: 3.3-4.3). Multivariate analysis confirmed that both scoring systems independently predicted survival, with hazard ratios similar to those provided by univariate analysis (respectively, 2.40 (95% confidence interval: 1.47-3.91) and 2.58 (95% confidence interval: 1.72-3.89) but the likelihood ratio increased from 19.6 of the International Prognostic Scoring System or 29.0 of the European Consensus on grading of bone MF to 42.3 when both measures were considered together. Analysis of the overall survival curves documented that patients classified as having the most favourable rate with both prognostic scores (ie low risk and MF-0) survive longer than those with only one favourable score (ie low risk but MF 0 or MF-0, but International Prognostic Scoring System low risk). In contrast, those patients classified as having the most unfavourable rate for both scores (high risk and MF-3) have a shorter survival than those with only one unfavourable score (ie high risk but MF3 or MF-3, but International Prognostic Scoring System high risk). In conclusion, our analysis suggests that better prognostication can be achieved in primary myelofibrosis patients when both systems are used together.

Original languageEnglish
Pages (from-to)1193-1202
Number of pages10
JournalModern Pathology
Volume25
Issue number9
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Primary Myelofibrosis
Fibrosis
Bone Marrow
Confidence Intervals
Survival
Survival Analysis
Multivariate Analysis

Keywords

  • European Consensus on grading of bone marrow fibrosis
  • International Prognostic Scoring System
  • primary myelofibrosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis. / Gianelli, Umberto; Vener, Claudia; Bossi, Anna; Cortinovis, Ivan; Iurlo, Alessandra; Fracchiolla, Nicola S.; Savi, Federica; Moro, Alessia; Grifoni, Federica; De Philippis, Chiara; Radice, Tommaso; Bosari, Silvano; Deliliers, Giorgio Lambertenghi; Cortelezzi, Agostino.

In: Modern Pathology, Vol. 25, No. 9, 09.2012, p. 1193-1202.

Research output: Contribution to journalArticle

Gianelli, Umberto ; Vener, Claudia ; Bossi, Anna ; Cortinovis, Ivan ; Iurlo, Alessandra ; Fracchiolla, Nicola S. ; Savi, Federica ; Moro, Alessia ; Grifoni, Federica ; De Philippis, Chiara ; Radice, Tommaso ; Bosari, Silvano ; Deliliers, Giorgio Lambertenghi ; Cortelezzi, Agostino. / The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis. In: Modern Pathology. 2012 ; Vol. 25, No. 9. pp. 1193-1202.
@article{b4dbe22260e9423993bd8829d26b7c5b,
title = "The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis",
abstract = "We investigated the relationship between the International Prognostic Scoring System of the International Working Group for Myelofibrosis Research and Treatment and the European Consensus on grading of bone marrow fibrosis (MF) in patients with primary myelofibrosis. We compared them in 196 consecutive primary myelofibrosis patients (median follow-up 45.7 months; range 7.4-159). International Prognostic Scoring System classified 42 cases as low risk, 73 as intermediate risk-1, 69 as intermediate risk-2, and 12 as high risk; European Consensus on grading of bone marrow fibrosis classified 83 cases as MF-0, 58 as MF-1, 41 as MF-2, and 14 as MF-3. By the time of the analysis, 30 patients (15.3{\%}) had died. Overall median survival was 3.8 years (95{\%} confidence interval: 3.3-4.3). Multivariate analysis confirmed that both scoring systems independently predicted survival, with hazard ratios similar to those provided by univariate analysis (respectively, 2.40 (95{\%} confidence interval: 1.47-3.91) and 2.58 (95{\%} confidence interval: 1.72-3.89) but the likelihood ratio increased from 19.6 of the International Prognostic Scoring System or 29.0 of the European Consensus on grading of bone MF to 42.3 when both measures were considered together. Analysis of the overall survival curves documented that patients classified as having the most favourable rate with both prognostic scores (ie low risk and MF-0) survive longer than those with only one favourable score (ie low risk but MF 0 or MF-0, but International Prognostic Scoring System low risk). In contrast, those patients classified as having the most unfavourable rate for both scores (high risk and MF-3) have a shorter survival than those with only one unfavourable score (ie high risk but MF3 or MF-3, but International Prognostic Scoring System high risk). In conclusion, our analysis suggests that better prognostication can be achieved in primary myelofibrosis patients when both systems are used together.",
keywords = "European Consensus on grading of bone marrow fibrosis, International Prognostic Scoring System, primary myelofibrosis",
author = "Umberto Gianelli and Claudia Vener and Anna Bossi and Ivan Cortinovis and Alessandra Iurlo and Fracchiolla, {Nicola S.} and Federica Savi and Alessia Moro and Federica Grifoni and {De Philippis}, Chiara and Tommaso Radice and Silvano Bosari and Deliliers, {Giorgio Lambertenghi} and Agostino Cortelezzi",
year = "2012",
month = "9",
doi = "10.1038/modpathol.2012.87",
language = "English",
volume = "25",
pages = "1193--1202",
journal = "Modern Pathology",
issn = "0893-3952",
publisher = "Nature Publishing Group",
number = "9",

}

TY - JOUR

T1 - The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis

AU - Gianelli, Umberto

AU - Vener, Claudia

AU - Bossi, Anna

AU - Cortinovis, Ivan

AU - Iurlo, Alessandra

AU - Fracchiolla, Nicola S.

AU - Savi, Federica

AU - Moro, Alessia

AU - Grifoni, Federica

AU - De Philippis, Chiara

AU - Radice, Tommaso

AU - Bosari, Silvano

AU - Deliliers, Giorgio Lambertenghi

AU - Cortelezzi, Agostino

PY - 2012/9

Y1 - 2012/9

N2 - We investigated the relationship between the International Prognostic Scoring System of the International Working Group for Myelofibrosis Research and Treatment and the European Consensus on grading of bone marrow fibrosis (MF) in patients with primary myelofibrosis. We compared them in 196 consecutive primary myelofibrosis patients (median follow-up 45.7 months; range 7.4-159). International Prognostic Scoring System classified 42 cases as low risk, 73 as intermediate risk-1, 69 as intermediate risk-2, and 12 as high risk; European Consensus on grading of bone marrow fibrosis classified 83 cases as MF-0, 58 as MF-1, 41 as MF-2, and 14 as MF-3. By the time of the analysis, 30 patients (15.3%) had died. Overall median survival was 3.8 years (95% confidence interval: 3.3-4.3). Multivariate analysis confirmed that both scoring systems independently predicted survival, with hazard ratios similar to those provided by univariate analysis (respectively, 2.40 (95% confidence interval: 1.47-3.91) and 2.58 (95% confidence interval: 1.72-3.89) but the likelihood ratio increased from 19.6 of the International Prognostic Scoring System or 29.0 of the European Consensus on grading of bone MF to 42.3 when both measures were considered together. Analysis of the overall survival curves documented that patients classified as having the most favourable rate with both prognostic scores (ie low risk and MF-0) survive longer than those with only one favourable score (ie low risk but MF 0 or MF-0, but International Prognostic Scoring System low risk). In contrast, those patients classified as having the most unfavourable rate for both scores (high risk and MF-3) have a shorter survival than those with only one unfavourable score (ie high risk but MF3 or MF-3, but International Prognostic Scoring System high risk). In conclusion, our analysis suggests that better prognostication can be achieved in primary myelofibrosis patients when both systems are used together.

AB - We investigated the relationship between the International Prognostic Scoring System of the International Working Group for Myelofibrosis Research and Treatment and the European Consensus on grading of bone marrow fibrosis (MF) in patients with primary myelofibrosis. We compared them in 196 consecutive primary myelofibrosis patients (median follow-up 45.7 months; range 7.4-159). International Prognostic Scoring System classified 42 cases as low risk, 73 as intermediate risk-1, 69 as intermediate risk-2, and 12 as high risk; European Consensus on grading of bone marrow fibrosis classified 83 cases as MF-0, 58 as MF-1, 41 as MF-2, and 14 as MF-3. By the time of the analysis, 30 patients (15.3%) had died. Overall median survival was 3.8 years (95% confidence interval: 3.3-4.3). Multivariate analysis confirmed that both scoring systems independently predicted survival, with hazard ratios similar to those provided by univariate analysis (respectively, 2.40 (95% confidence interval: 1.47-3.91) and 2.58 (95% confidence interval: 1.72-3.89) but the likelihood ratio increased from 19.6 of the International Prognostic Scoring System or 29.0 of the European Consensus on grading of bone MF to 42.3 when both measures were considered together. Analysis of the overall survival curves documented that patients classified as having the most favourable rate with both prognostic scores (ie low risk and MF-0) survive longer than those with only one favourable score (ie low risk but MF 0 or MF-0, but International Prognostic Scoring System low risk). In contrast, those patients classified as having the most unfavourable rate for both scores (high risk and MF-3) have a shorter survival than those with only one unfavourable score (ie high risk but MF3 or MF-3, but International Prognostic Scoring System high risk). In conclusion, our analysis suggests that better prognostication can be achieved in primary myelofibrosis patients when both systems are used together.

KW - European Consensus on grading of bone marrow fibrosis

KW - International Prognostic Scoring System

KW - primary myelofibrosis

UR - http://www.scopus.com/inward/record.url?scp=84865714762&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865714762&partnerID=8YFLogxK

U2 - 10.1038/modpathol.2012.87

DO - 10.1038/modpathol.2012.87

M3 - Article

VL - 25

SP - 1193

EP - 1202

JO - Modern Pathology

JF - Modern Pathology

SN - 0893-3952

IS - 9

ER -