Impact of red blood cell transfusion requiring anemia on the natural history of Myeloproliferative Neoplasm Associated Myelofibrosis

Publication date: Available online 21 September 2015 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Justyna Bartoszko, Tony Panzarella, Anthea Lau, Aaron Schimmer, Andre Schuh, Mohamed Shanavas, Karen Yee, Vikas Gupta There are two widely-used criteria for red blood cell (RBC) transfusion dependence in persons with myeloproliferative neoplasm (MPN)-associated myelofibrosis: (1) the International Working Group-Myelofibrosis Research and Therapy (IWG-MRT) criteria (2U RBCs in the preceding one month); and (2) the RAND-Delphi definition (2U RBC/month averaged over 3 months). We studied impact of these criteria on survival and risk of leukemic transformation in 259 subjects with MPN-associated myelofibrosis. Based on haemoglobin (Hb) and transfusion history, subjects were assigned into one of the 4 cohorts: (1) Hb ≥100 g/l (n=136, 52%) and no RBC transfusions in the preceding 4 months; (2) Hb <100 g/L, no RBC transfusions in the preceding 4 months (n=56, 22%); (3) subjects meeting IWG-MRT criteria, but not the Rand-Delphi criteria for RBC-transfusion dependence (n=34, 13%); and (4) subjects meeting the Rand-Delphi criteria for RBC-transfusion dependence (n=33, 13%). Three-year probability of survival among the 4 cohorts was 81% (95% CI 71-87), 55% (95% CI 36-71), 52% (95% CI 31-69), and 47% (95% CI 24-67), respectively (p=0.0005). There was no significant difference in baseline characteristics or survival between cohorts 3 and 4 and they wer...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research