Clinical and laboratory characteristics of 414 patients with primary myelofibrosis studied for serum albumin level and 318 patients studied for serum total cholesterol
| Characteristic . | Serum albumin <4.3 g/dL (n = 285), . | Serum albumin ≥4.3 g/dL (n = 129), . | P . | Serum total cholesterol <122 mg/dL (n = 119), . | Serum total cholesterol ≥122 mg/dL (n = 199), . | P . |
|---|---|---|---|---|---|---|
| n (%) . | n (%) . | n (%) . | n (%) . | |||
| Age, y | ||||||
| Median (range) | 67 (22-92) | 61 (19-84) | <.001 | 64 (26-86) | 61 (19-88) | .02 |
| >65 | 157 (55) | 44 (34) | <.001 | 53 (45) | 79 (40) | .4 |
| Males | 182 (64) | 71 (55) | .09 | 93 (78) | 108 (54) | <.001 |
| Hemoglobin <10 g/dL | 172 (60) | 42 (33) | <.001 | 68 (57) | 78 (39) | .002 |
| Requiring transfusion | 121 (43) | 29 (23) | <.001 | 48 (40) | 46 (23) | .001 |
| Leukocytes >25 × 109/L | 56 (20) | 10 (8) | .001 | 20 (17) | 26 (13) | .36 |
| Platelets <100 × 109/L | 87 (31) | 23 (18) | .006 | 29 (24) | 45 (23) | .72 |
| Circulating blasts ≥1% | 156 (55) | 44 (34) | <.001 | 73 (61) | 87 (44) | .002 |
| Constitutional symptoms | 113 (40) | 26 (20) | <.001 | 50 (42) | 45 (23) | <.001 |
| DIPSS risk distribution* | <.001 | <.001 | ||||
| High | 46 (16) | 2 (1.6) | 14 (12) | 13 (7) | ||
| Intermediate-2 | 126 (44) | 39 (30) | 66 (56) | 65 (33) | ||
| Intermediate-1 | 96 (34) | 54 (42) | 26 (22) | 76 (38) | ||
| Low | 17 (6) | 34 (26) | 13 (11) | 45 (23) | ||
| DIPSS-plus risk distribution (no. evaluable: 411 [albumin]; 316 [cholesterol])† | < .001 | <.001 | ||||
| High | 123 (43) | 23 (18) | 50 (42) | 50 (25) | ||
| Intermediate-2 | 109 (38) | 46 (36) | 46 (39) | 65 (33) | ||
| Intermediate-1 | 37 (13) | 29 (23) | 12 (10) | 41 (21) | ||
| Low | 15 (5) | 29 (23) | 11 (9) | 41 (21) | ||
| Driver mutations (no. evaluable: 277 [albumin]; 234 [cholesterol]) | .67 | .005 | ||||
| JAK2 | 122 (69) | 63 (64) | 64 (75) | 83 (56) | ||
| CALR type 1–like | 31 (17) | 21 (21) | 5 (6) | 34 (23) | ||
| CALR type 2–like | 6 (3) | 2 (2) | 3 (4) | 7 (5) | ||
| MPL | 7 (4) | 7 (7) | 3 (4) | 9 (6) | ||
| Triple-negative | 12 (7) | 6 (6) | 10 (12) | 16 (11) | ||
| Revised cytogenetic risk distribution (no. evaluable: 389 [albumin]; 303 [cholesterol])‡ | .14 | .12 | ||||
| Very high risk | 29 (11) | 6 (5) | 8 (7) | 5 (3) | ||
| Unfavorable | 43 (16) | 22 (18) | 14 (12) | 32 (17) | ||
| Favorable | 196 (73) | 93 (77) | 95 (81) | 149 (80) | ||
| ASXL1-mutated (no. evaluable: 201 [albumin]; 191 [cholesterol]) | 51 (40) | 20 (27) | .06 | 42 (58) | 39 (33) | <.001 |
| SRSF2-mutated (no. evaluable: 204 [albumin]; 191 [cholesterol]) | 21 (16) | 13 (17) | P = .89 | 13 (18) | 10 (8) | .06 |
| Characteristic . | Serum albumin <4.3 g/dL (n = 285), . | Serum albumin ≥4.3 g/dL (n = 129), . | P . | Serum total cholesterol <122 mg/dL (n = 119), . | Serum total cholesterol ≥122 mg/dL (n = 199), . | P . |
|---|---|---|---|---|---|---|
| n (%) . | n (%) . | n (%) . | n (%) . | |||
| Age, y | ||||||
| Median (range) | 67 (22-92) | 61 (19-84) | <.001 | 64 (26-86) | 61 (19-88) | .02 |
| >65 | 157 (55) | 44 (34) | <.001 | 53 (45) | 79 (40) | .4 |
| Males | 182 (64) | 71 (55) | .09 | 93 (78) | 108 (54) | <.001 |
| Hemoglobin <10 g/dL | 172 (60) | 42 (33) | <.001 | 68 (57) | 78 (39) | .002 |
| Requiring transfusion | 121 (43) | 29 (23) | <.001 | 48 (40) | 46 (23) | .001 |
| Leukocytes >25 × 109/L | 56 (20) | 10 (8) | .001 | 20 (17) | 26 (13) | .36 |
| Platelets <100 × 109/L | 87 (31) | 23 (18) | .006 | 29 (24) | 45 (23) | .72 |
| Circulating blasts ≥1% | 156 (55) | 44 (34) | <.001 | 73 (61) | 87 (44) | .002 |
| Constitutional symptoms | 113 (40) | 26 (20) | <.001 | 50 (42) | 45 (23) | <.001 |
| DIPSS risk distribution* | <.001 | <.001 | ||||
| High | 46 (16) | 2 (1.6) | 14 (12) | 13 (7) | ||
| Intermediate-2 | 126 (44) | 39 (30) | 66 (56) | 65 (33) | ||
| Intermediate-1 | 96 (34) | 54 (42) | 26 (22) | 76 (38) | ||
| Low | 17 (6) | 34 (26) | 13 (11) | 45 (23) | ||
| DIPSS-plus risk distribution (no. evaluable: 411 [albumin]; 316 [cholesterol])† | < .001 | <.001 | ||||
| High | 123 (43) | 23 (18) | 50 (42) | 50 (25) | ||
| Intermediate-2 | 109 (38) | 46 (36) | 46 (39) | 65 (33) | ||
| Intermediate-1 | 37 (13) | 29 (23) | 12 (10) | 41 (21) | ||
| Low | 15 (5) | 29 (23) | 11 (9) | 41 (21) | ||
| Driver mutations (no. evaluable: 277 [albumin]; 234 [cholesterol]) | .67 | .005 | ||||
| JAK2 | 122 (69) | 63 (64) | 64 (75) | 83 (56) | ||
| CALR type 1–like | 31 (17) | 21 (21) | 5 (6) | 34 (23) | ||
| CALR type 2–like | 6 (3) | 2 (2) | 3 (4) | 7 (5) | ||
| MPL | 7 (4) | 7 (7) | 3 (4) | 9 (6) | ||
| Triple-negative | 12 (7) | 6 (6) | 10 (12) | 16 (11) | ||
| Revised cytogenetic risk distribution (no. evaluable: 389 [albumin]; 303 [cholesterol])‡ | .14 | .12 | ||||
| Very high risk | 29 (11) | 6 (5) | 8 (7) | 5 (3) | ||
| Unfavorable | 43 (16) | 22 (18) | 14 (12) | 32 (17) | ||
| Favorable | 196 (73) | 93 (77) | 95 (81) | 149 (80) | ||
| ASXL1-mutated (no. evaluable: 201 [albumin]; 191 [cholesterol]) | 51 (40) | 20 (27) | .06 | 42 (58) | 39 (33) | <.001 |
| SRSF2-mutated (no. evaluable: 204 [albumin]; 191 [cholesterol]) | 21 (16) | 13 (17) | P = .89 | 13 (18) | 10 (8) | .06 |
Patients were stratified by ROC-determined cutoff points for albumin and total cholesterol. The values in bold indicate a significant P value (< .05).
DIPSS uses 5 independent predictors of inferior survival: age >65 years, hemoglobin <10 g/dL, leukocytes >25 × 109/L, circulating blasts ≥1%, and constitutional symptoms.
DIPSS-plus includes all the DIPSS variables plus 3 more: red cell transfusion need, platelet count <100 × 109/L, and unfavorable karyotype.
Revised cytogenetic risk stratification: very high risk includes single or multiple abnormalities of −7, i(17q), inv(3)/3q21, 12p-/12p11.2, 11q–/11q23, +21, or other autosomal trisomies, not including +8/+9; favorable risk includes normal karyotype or sole abnormalities of 13q–, +9, 20q–, chromosome 1 translocation, or duplication or sex chromosome abnormality including –Y; unfavorable risk includes all other abnormalities.
ASXL1, additional sex combs–like 1; CALR, calreticulin; JAK2, Janus kinase 2; MPL, myeloproliferative leukemia virus oncogene; SRSF2, serine/arginine-rich splicing factor 2.