Red blood cell transfusion need at diagnosis adversely affects survival in primary myelofibrosis-increased serum ferritin or transfusion load does not.
Serum ferritin level at diagnosis was available in 185 patients with primary myelofibrosis (PMF); twenty-two (12%) patients had serum ferritin >1,000 ng/mL and 32 (17%) were red blood cell (RBC) transfusion-dependent. As expected, RBC transfusion need and increased serum ferritin displayed strong correlation (P < 0.0001); in addition, the latter but not the former correlated with advanced age (P < 0.0001). During median follow-up of 28 months (range 0.5-231), peak serum ferritin levels exceeded 1,000 ng/mL in 41 (22%) patients. On multivariable analysis that included age as a covariate, RBC transfusion need at diagnosis (P < 0.0001), but not increased serum ferritin or transfusion load, predicted shortened survival. The prognostic relevance of RBC transfusion need was independent of the International Prognostic Scoring System and was also illustrated for leukemia-free survival (P = 0.003). In PMF, the presence of a more severe erythropoietic defect, and not iron overload, has additional adverse prognostic value.
Tefferi
Ayalew
A
Division of Hematology Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. tefferi.ayalew@mayo.edu
Mesa
Ruben A
RA
Pardanani
Animesh
A
Hussein
Kebede
K
Schwager
Susan
S
Hanson
Curtis A
CA
Steensma
David P
DP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017707:Erythrocyte Transfusion; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D019190:Iron Overload / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult
D005293:Ferritins