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Myelofibrosis has a variable prognosis depending on whether it is primary or secondary, the severity of alterations in peripheral blood counts, the presence of circulating blasts, and chromosomal abnormalities. The Dynamic International Prognostic Scoring System (DIPSS) includes eight risk factors for poor outcome or death in primary myelofibrosis: unfavorable karyotype, blast percentage ≥1%, platelets <100,000/μL, white blood cell (WBC) count >25,000/μL, hemoglobin level <10 g/dL, red blood cell transfusion requirement, constitutional symptoms, and age >65 (Blood 2010; 115:1703).
To refine this prognostic system, investigators studied outcomes in patients with primary myelofibrosis. After a median 8.2 years of follow-up, deaths occurred in …