Considering specific risk factors may help identify patients with myelofibrosis who are candidates for splenectomy, according to a study involving 120 individuals. Participants were a median 66 years of age and had myelofibrosis. Investigators looked at risk factors impacting postsplenectomy survival, and found that it was adversely affected by older age, transfusion need, high leukocyte count, and high circulating blasts. They used this information to develop a scoring system with high, intermediate, and low risk categories, and determined that:

• The corresponding postsplenectomy median survival lengths in the high, intermediate, and low risk groups were 0.3, 1.3, and 2.9 years, respectively.
• Postsplenectomy survival was not affected by driver mutational status or occurrence of leukemic transformation.
• Leukemia-free survival was predicted by very high-risk karyotype.