Passamonti et al reported the MYSEC-PM score for evaluating a patient with myelofibrosis secondary to polycythemia or essential thrombocythemia. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Europe and the United States.
MYSEC-PM stands for Myelofibrosis Secondary to PV and ET Prognostic Model
Patient selection: myelofibrosis following polycythemia or essential thrombocythemia
Parameters:
(1) age in years at time of diagnosis of secondary myelofibrosis
(2) hemoglobin in g/dL
(3) platelet count in 10^9/L
(4) circulating blasts in percent
(5) CALR genotype (unmutated corresponds to JAK2 mutated, MPL mutated, and triple negative)
(6) constitutional symptoms
Parameter
Finding
Points
age at diagnosis
0.15 * (age)
hemoglobin
>= 11 g/dL
0
< 11 g/dL
2
platelet count
>= 150 * 10^9/L
0
< 150 * 10^9/L
1
circulating blasts
< 3%
0
>= 3%
2
CALR genotype
mutated
0
unmutated
2
constitutional symptoms
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: < 5 (depends on age at diagnosis)
• maximum score: 24
Total Score
Risk Category
Median Survival
< 11
low
not reached
11 to 13.95
intermediate 1
9.3 years
14 to 15.95
intermediate 2
4.4 years
>= 16
high
2 years
Performance:
• The C-statistic is 0.78.
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