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Myeloid blastic transformation of myeloproliferative neoplasms--a review of 112 cases.

Abstract：

:Blastic transformation of myeloproliferative neoplasms (MPN) is still poorly understood. We describe a cohort of 23 Roswell Park Cancer Institute (RPCI) patients and 89 additional cases from the English literature for whom biologic features were described. We initially compared our 23 patients to the 89 cases from the literature. Our population had significantly less patients with prior history of polycythemia vera (PV), shorter time from MPN diagnosis to blastic transformation, <3 prior therapies, more frequent use of hydroxyurea and erythropoietin and less frequent use of alkylating agents. Interestingly, the overall survival of the two cohorts from the time of blastic transformation was similar. We therefore looked at the outcome of the entire cohort (n=112). Patients with prior history of essential thrombocythemia survived longer than patients with prior history of myelofibrosis or PV. Further, patients with <3 prior therapies, those who lacked complex karyotype and those <60 year old at MPN diagnosis had significantly longer survival. Among the PRCI population, 20/23 patients underwent induction treatment with cytarabine and an anthracycline containing regimens; 12 achieved remission and their overall survival was significantly longer than those who did not. Three patients underwent an allogeneic transplantation and their survival was significantly longer than those who did not. Patients with <3 prior therapies, those who lack complex karyotype and those <60 at MPN diagnosis have longer survival following blastic transformation. Finally, allogeneic transplantation represents the only chance for long-term survival in these patients.

journal_name

Leuk Res

journal_title

Leukemia research

authors

Noor SJ,Tan W,Wilding GE,Ford LA,Barcos M,Sait SN,Block AW,Thompson JE,Wang ES,Wetzler M

doi

10.1016/j.leukres.2010.07.031

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

608-13

issue

5

eissn

0145-2126

issn

1873-5835

pii

S0145-2126(10)00374-7

journal_volume

35

pub_type

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