of patients will have intermediate-2 or high-risk disease at diagnosis3
MYELOFIBROSIS PROGRESSION is often incessant and not always apparent1,2
In some studies, extensive BMF was shown to contribute to impaired hematopoiesis and clinical features including, but not limited to, splenomegaly8-11
Higher-grade BMF has been shown to correlate with poor survival12,13
- A retrospective study showed that patients with a higher-grade BMF had an ≈3-fold decrease in median survival vs patients with a BMF of ≤1 (P<0.001)12
In some studies, higher grades of BMF have been associated with clinical manifestations of myelofibrosis, including8,14:
BMF=bone marrow fibrosis; DIPSS=Dynamic International Prognostic Scoring System; IPSS=International Prognostic Scoring System; JAK/STAT=Janus kinase signal transducer and activator of transcription; MF=myelofibrosis; OS=overall survival.
References:
- Kramann R, Schneider RK. The identification of fibrosis-driving myofibroblast precursors reveals new therapeutic avenues in myelofibrosis. Blood. 2018;131(19):2111-2119. doi:10.1182/blood-2018-02-834820
- Palandri F, Al-Ali HK, Guglielmelli P, et al. Impact of bone marrow fibrosis grade on response and outcomes in patients with primary myelofibrosis treated with ruxolitinib: a post-hoc analysis of the JUMP study. Poster EP1092 presented at: EHA2021; June 9-17, 2021; Virtual Congress.
- Tefferi A, Lasho TL, Jimma T, et al. One thousand patients with primary myelofibrosis: the Mayo Clinic experience. Mayo Clin Proc. 2012;87(1):25-33. doi:10.1016/j.mayocp.2011.11.001
- Pettit K, Odenike O. Novel therapies for myelofibrosis. Curr Hematol Malig Rep. 2017;12(6):611-624. doi:10.1007/s11899-017-0403-0
- Gangat N, Caramazza D, Vaidya R, et al. DIPSS Plus: a refined Dynamic International Prognostic Scoring System for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count, and transfusion status. J Clin Oncol. 2011;29(4):392-397. doi:10.1200/JCO.2010.32.2446
- Reilly JT, McMullin MF, Beer PA, et al. Guideline for the diagnosis and management of myelofibrosis. Br J Hematol. 2012;158(4):453-471. doi:10.1111/j.1365-2141.2012.09179
- Mesa RA, Miller CB, Thyne M, et al. Myeloproliferative neoplasms (MPNs) have a significant impact on patients’ overall health and productivity: the MPN Landmark survey. BMC Cancer. 2016;16:167. doi:10.1186/s12885-016-2208-2
- Zahr AA, Salama ME, Carreau N, et al. Bone marrow fibrosis in myelofibrosis: pathogenesis, prognosis and targeted strategies. Haematologica. 2016;101(6):660-671. doi:10.3324/haematol.2015.141283
- Gleitz HFE, Kramann R, Schneider RK. Understanding deregulated cellular and molecular dynamics in the haematopoietic stem cell niche to develop novel therapeutics for bone marrow fibrosis. J Pathol. 2018;245(2):138-146. doi:0.1002/path.5078
- Agarwal A, Morrone K, Bartenstein M, Zhao ZJ, Verma A, Goel S. Bone marrow fibrosis in primary myelofibrosis: pathogenic mechanisms and the role of TGF-β. Stem Cell lnvestig. 2016;3(5):1-10. doi:10.3978/j.issn.2306-9759.2016.02.03
- Gleitz HFE, Pritchard JE, Kramann R, Schneider RK. Fibrosis driving myofibroblast precursors in MPN and new therapeutic pathways. HemaSphere. 2019;3(S2):142-145. doi:10.1097/HS9.0000000000000216
- Lekovic D, Gotic M, Perunicic-Jovanovic, et al. Contribution of comorbidities and grade of bone marrow fibrosis to the prognosis of survival in patients with primary myelofibrosis. Med Oncol. 2014;31(3):869. doi:10.1007/s12032-014-0869-8
- Gianelli U, Vener C, Bossi A, et al. The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis. Mod Pathol. 2012;25(9):1193-1202. doi:10.1038/modpathol.2012.87
- Nazha A, Estrov Z, Cortes J, Bueso-Ramos CE, Kantarjian H, Verstovsek S. Prognostic implications and clinical characteristics associated with bone marrow fibrosis in patients with myelofibrosis. Leuk Lymphoma. 2013;54(11):2537-2539. doi:10.3109/10428194.2013.769537