title: Predictive factors for anemia response to erythropoiesis-stimulating agents in myelofibrosis.
abstract: OBJECTIVE
  Erythropoiesis-stimulating agents (ESAs) are commonly used to treat the anemia of myelofibrosis (MF), but information on the predictors of response is limited.
  
  
  METHODS
  Results of ESA therapy were analyzed in 163 MF patients with severe anemia, most of whom had inadequate erythropoietin (EPO) levels (<125 U/L) at treatment start.
  
  
  RESULTS
  According to the revised criteria of the International Working Group for Myelofibrosis Treatment and Research, anemia response was achieved in 86 patients (53%). Median response duration was 19.3 months. In multivariate analysis, baseline factors associated with a higher response rate were female sex (P=.007), leukocyte count ≥10×109/L (P=.033), and serum ferritin <200 ng/mL (P=.002). Patients with 2 or 3 of the above features had a significantly higher response rate than the remainder (73% vs 28%, respectively; P<.001). Over the 373 patient-years of follow-up on ESA treatment, nine patients developed thrombotic complications (six arterial, three venous), accounting for 2.41 events per 100 patient-years. Survival time from ESA start was longer in anemia responders than in non-responders (P=.011).
  
  
  CONCLUSIONS
  Besides the already established predictive value of EPO levels, these data can help to identify which MF patients are more likely to benefit from ESA treatment.
authors.affiliation: Hematology Department, Hospital Clínico Universitario, INCLIVA, Valencia, Spain.
authors.forename: Juan-Carlos
authors.initials: JC
authors.lastname: Hernández-Boluda
authors.affiliation: Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Juan-Gonzalo
authors.initials: JG
authors.lastname: Correa
authors.affiliation: Hematology Department, Hospital Virgen de la Victoria, Málaga, Spain.
authors.forename: Regina
authors.initials: R
authors.lastname: García-Delgado
authors.affiliation: Hematology Department, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Martínez-López
authors.affiliation: Hematology Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alvarez-Larrán
authors.affiliation: Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: María-Laura
authors.initials: ML
authors.lastname: Fox
authors.affiliation: Hematology Department, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Valentín
authors.initials: V
authors.lastname: García-Gutiérrez
authors.affiliation: Hematology Department, Hospital Clínico, Santiago de Compostela, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pérez-Encinas
authors.affiliation: Hematology and Medical Oncology Department, Hospital Morales Meseguer, IMIB-Arrixaca, UCAM, Murcia, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: Ferrer-Marín
authors.affiliation: Hematology Department, Hospital Costa del Sol, Marbella, Spain.
authors.forename: María-Isabel
authors.initials: MI
authors.lastname: Mata-Vázquez
authors.affiliation: Hematology Department, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: José-María
authors.initials: JM
authors.lastname: Raya
authors.affiliation: Hematology Department, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Estrada
authors.affiliation: Hematology Department, Hospital La Fe, IIS La Fe, Valencia, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: García
authors.affiliation: Hematology Department, Hospital La Paz, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Kerguelen
authors.affiliation: Hematology Department, Hospital Son Espases, Mallorca, Spain.
authors.forename: María-Antonia
authors.initials: MA
authors.lastname: Durán
authors.affiliation: Hematology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Albors
authors.affiliation: Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Cervantes
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D018572:Disease-Free Survival; D004921:Erythropoietin / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D006397:Hematinics / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D013927:Thrombosis / Q000097:blood / Q000139:chemically induced / Q000401:mortality
chemical_list: C554270:EPO protein, human; D006397:Hematinics; D004921:Erythropoietin; D005293:Ferritins
keywords: anemia; erythropoiesis-stimulating agents; myelofibrosis; predictive factors; treatment