Maisonneuve-Rosemont Hospital Université de Montréal

Myelofibrosis

Prognostic score: International working group for myelofibrosis (at diagnosis)

Risk group No. of factors Median survival (mo; 95% CI) Proportion of deaths, %
Low 0 135 (117-181) 32
Intermediate-1 1 95 (79-114) 50
Intermediate-2 2 48 (43-59) 71
High > 3 27 (23-31) 73

The presence of an abnormal karyotype contributes to a worse prognosis only in the intermediate risk group (1 and 2).

Prognostic factors: At any time during follow up

Factors associated with a poor prognosis at diagnosis or during follow up ; each of these factors is associated with a median survival of less than 12 months :

Indications for allogeneic transplant

We recommend proceeding with transplant in the intermediate 2 and high risk categories up until the ages of 65 with a related donor and until 60 with an unrelated donor.

A patient that has any of the 3 poor prognostic features listed above becomes eligible regardless of the risk category.

In certain situations, an allogeneic transplant will be considered in younger patients in the intermediate 1 risk category if an additional poor prognostic feature is present (example: transfusion dependence not responding to other therapies).

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