Adding cytogenetics, thrombocytopenia, and red cell transfusion dependence as risk factors appears to improve the Dynamic International Prognostic Scoring System (DIPSS), according to a study involving 233 individuals with myelofibrosis (MF). Investigators sought to determine if the enhanced system would predict post- hematopoietic cell transplantation (HCT) outcomes better than DIPSS-alone. Among the results:

• 5-year overall survival rate for patients with low/int-1 risk MF was 78%.
• Relapse and treatment-related mortality rates were 5% and 20%, respectively.
• 5-year overall survival rate in patients with high-risk MF was 35%.
• Relapse and treatment-related mortality rates were 28% and 40%, respectively.
• HCT-comorbidity index of ≥3 was linked with higher non-relapse and overall mortality, and lower relapse-free survival.
• Older patients were 3 times more likely to experience relapse.
• At a median follow-up of 8 years, ~half of patients had survived.

The authors noted that the findings may help improve the ability to advise patients about transplant timing.