Risk models predicting survival after reduced-intensity transplantation for myelofibrosis

To define a prognostic model for predicting outcome of reduced-intensity allogeneic stem cell transplantation (RIC-ASCT) for myelofibrosis we evaluated 150 homogenously treated patients and developed a new risk score for overall survival (OS). In a multivariate Cox model for OS, only JAK2 V617F wild-type, age =57 years and constitutional symptoms were independently predictive for OS (Hazard Ratio: 22 02; 2 43 and 2 80 respectively). Depending on the presence of one, two or all of these factors, HR of death was 3 08; 4 70 and 16 61 respectively ( P < 0 001). This score was compared to the Lille, Cervantes, International Prognostic Scoring System ( IPSS), dynamic IPSS ( DIPSS) and modified European Blood and Marrow Transplantation Group ( EBMT) scores. Lille score correlated significantly with OS but discriminated poorly between the intermediate and high- risk groups ( 5- year OS 56% and 51% respectively). IPSS and DIPSS correlated significantly with OS but differences between intermediate- 1 and intermediate- 2 groups were not significant ( 5- year OS 78% vs. 78% and 70%, 60% respectively). Modified EBMT and Cervantes models did not predict OS post- ASCT. In conclusion, a simple model which includes: age, JAK2 V617F- status and constitutional symptoms can clearly separate distinct risk groups and can be used in addition to the Lille model to predict OS after RIC- ASCT for myelofibrosis.