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The number of prognostically detrimental mutations and prognosis in primary myelofibrosis: an international study of 797 patients

Open access
Guglielmelli, P, Lasho, T L, Rotunno, G, Score, J, Mannarelli, C, Pancrazzi, A, Biamonte, F, Pardanani, A, Zoi, K, Reiter, A, Duncombe, A, Fanelli, T, Pietra, D, Rumi, E, Finke, C, Gangat, N, Ketterling, R P, Knudson, R A, Hanson, C A, Bosi, A, Pereira, A, Manfredini, R, Cervantes, F, Barosi, G, Cazzola, M, Cross, N C P, Vannucchi, A M, Tefferi, A·2014·Leukemia

Abstract

We recently defined a high-molecular risk category (HMR) in primary myelofibrosis (PMF), based on the presence of at least one of the five ‘prognostically detrimental’ mutated genes (ASXL1, EZH2, SRSF2 and IDH1/2). Herein, we evaluate the additional prognostic value of the ‘number’ of mutated genes. A total of 797 patients were recruited from Europe (n=537) and the Mayo Clinic (n=260). In the European cohort, 167 (31%) patients were HMR: 127 (23.6%) had one and 40 (7.4%) had two or more mutated genes. The presence of two or more mutations predicted the worst survival: median 2.6 years (hazard ratio (HR) 3.8, 95% confidence interval (CI) 2.6–5.7) vs 7.0 years (HR 1.9, 95% CI 1.4–2.6) for one mutation vs 12.3 years for no mutations. The results were validated in the Mayo cohort and prognostic significance in both cohorts was independent of International Prognostic Scoring System (IPSS; HR 2.4, 95% CI 1.6–3.6) and dynamic IPSS (DIPSS)-plus (HR 1.9, 95% CI 1.2–3.1), respectively. Two or more mutations were also associated with shortened leukemia-free survival (HR 6.2, 95% CI 3.5–10.7), also Mayo validated. Calreticulin mutations favorably affected survival, independently of both number of mutations and IPSS/DIPSS-plus. We conclude that the ‘number’ of prognostically detrimental mutations provides added value in the combined molecular and clinical prognostication of PMF.

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Metadata

Authors
Guglielmelli, P., Lasho, T. L., Rotunno, G., Score, J., Mannarelli, C., Pancrazzi, A., Biamonte, F., Pardanani, A., Zoi, K., Reiter, A., Duncombe, A., Fanelli, T., Pietra, D., Rumi, E., Finke, C., Gangat, N., Ketterling, R. P., Knudson, R. A., Hanson, C. A., Bosi, A., Pereira, A., Manfredini, R., Cervantes, F., Barosi, G., Cazzola, M., Cross, N. C. P., Vannucchi, A. M., & Tefferi, A.
Venue
Leukemia
Published
2014-02-19
Volume
28
Issue
9
Pages
1804-1810
ISSN
  • 0887-6924 (ISSN-L)
  • 1476-5551
OpenAlex
W2024401882
Cited by
310
References
18
FWCI
18.01
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: The number of prognostically detrimental mutations and prognosis in primary myelofibrosis: an international study of 797 patients. https://app.cochat.ai/papers/10.1038/leu.2014.76
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Guglielmelli, P., Lasho, T. L., Rotunno, G., Score, J., Mannarelli, C., Pancrazzi, A., Biamonte, F., Pardanani, A., Zoi, K., Reiter, A., Duncombe, A., Fanelli, T., Pietra, D., Rumi, E., Finke, C., Gangat, N., Ketterling, R. P., Knudson, R. A., Hanson, C. A., . . . Tefferi, A. (2014). The number of prognostically detrimental mutations and prognosis in primary myelofibrosis: an international study of 797 patients. Leukemia. https://doi.org/10.1038/leu.2014.76

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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