Myelofibrosis: Prognostication and cytoreductive treatment

作     者：Margherita Maffioli Domenica Caramazza Barbara Mora Michele Merli Francesco Passamonti 

作者机构：Division of HematologyDepartment of MedicineUniversity Hospital Ospedale di Circolo e Fondazione Macchi21100 VareseItaly 

出 版 物：《World Journal of Hematology》 (世界血液学杂志)

年 卷 期：2014年第3卷第3期

页      面：85-92页

学科分类：10[医学] 

主　　题：Myelofibrosis Prognosis JAK2 Ruxolitinib Fedratinib Momelotinib 

摘      要：Myeloproliferative neoplasms include three diseases: polycythemia vera, essential thrombocythemia and primary myelofibrosis(PMF), currently diagnosed according to the 2008 World Health Organization criteria. Patients with PMF may encounter many complications, and, among these, disease progression is the most severe. Concerning prognostication of Myelofibrosis(MF), the International Prognostic scoring system(IPSS)(International Prognostic Scoring System) model at diagnosis and the Dynamic IPSS(DIPSS) anytime during the course of the disease may be useful to define survival of MF patients. The IPSS and the DIPSS are based on age greater than 65 years, presence of constitutional symptoms, hemoglobin level less than 10 g/d L, leukocyte count greater than 25 × 109/L, and circulating blast cells 1% or greater. Cytogenetic profile and mutational analysis seem to be the next step to implement MF prognostication. Concerning treatments, hydroxyurea has been considered until now the drug of choice when an anti-myeloproliferative effect is needed, but recent data on JAK inhibitors demonstrated a significant effect of these drugs on splenomegaly and symptoms.