Table 2.
Clinical and laboratory characteristics of 248 patients with blast phase myeloproliferative neoplasms at the time of leukemic transformation, stratified by their overall management and response categories
| Variables | All patients (n = 248) | Patients not transplanted and received supportive care only (n = 121) | Patients not transplanted but received chemotherapy with no response (n = 79) | Patients not transplanted but achieved CR/CRi with chemotherapy (n = 24) | Patients transplanted directly or after failing chemotherapy (n = 8) | Patients transplanted in CR or CRi with pre-transplant chemotherapy (n = 16) | P-value |
|---|---|---|---|---|---|---|---|
| Age in years; median (range) | 67 (40–90) | 70 (40–90) | 66 (46–90) | 63 (45–82) | 57 (44–68) | 56 (42–70) | <0.0001 |
| Age > 65 years; n (%) | 140 (56) | 87 (72) | 42 (53) | 9 (38) | 1 (13) | 1 (6) | <0.0001 |
| Sex (male); n (%) | 161 (65) | 80 (66) | 52 (66) | 13 (54) | 6 (75) | 10 (63) | 0.8 |
| Transfusion dependent; n (%) “N” evaluable = 233 | 80 (34) | 41 (38) | 31 (39) | 4 (17) | 2 (29) | 2 (13) | 0.08 |
| Hemoglobin, g/dl; median (range) “N” evaluable = 217 | 9.3 (0.7–18.1) | 9.4 (5.8–14.1) | 8.9 (0.7–14.5) | 9.5 (6.3–15.8) | 8.7 (7.9–14.1) | 9.6 (6.9–18.1) | 0.7 |
| Platelets x 109/L; median (range) “N” evaluable = 216 | 78 (3–2051) | 77 (3–2051) | 80 (6–691) | 109 (11–1246) | 73 (43–1126) | 67 (15–412) | 0.9 |
| Platelets < 100 × 109/L; n (%) “N” evaluable = 216 | 126 (58) | 62 (61) | 41 (59) | 11 (48) | 3 (60) | 9 (56) | 0.9 |
| Leukocytes x 109/L; median (range) “N” evaluable = 218 | 15.9 (0.4–600) | 15.5 (0.5–145.5) | 22.3 (0.6–151.1) | 14.6 (0.4–600) | 55.1 (2.1–154.1) | 5.8 (1.6–56.8) | 0.1 |
| Leukocytes > 25 × 109/L; n (%) “N” evaluable = 218 | 81 (37) | 37 (36) | 30 (42) | 8 (35) | 3 (60) | 3 (19) | 0.4 |
| Circulating blasts %; median (range) “N” evaluable = 215 | 26 (0–99) | 27 (0–88) | 26 (0–99) | 31 (0–76) | 22 (10–89) | 22 (10–76) | 0.9 |
| Circulating blasts ≥ 20%; n (%) “N” evaluable = 215 | 152 (71) | 74 (73) | 49 (69) | 15 (68) | 3 (60) | 11 (69) | 0.9 |
| Bone marrow blasts %; median (range) “N” evaluable = 180 | 33 (1–97) | 34 (3–95) | 30 (1–97) | 47 (5–92) | 29 (8–58) | 32 (8–79) | 0.3 |
| Bone marrow blasts ≥ 20%; n (%) “N” evaluable = 180 | 156 (87) | 69 (90) | 53 (84) | 20 (91) | 3 (75) | 11 (79) | 0.6 |
| Karyotype “N” evaluable = 172 Normal; n (%) Abnormal; n (%) | 32 (19) 140 (81) | 9 (13) 59 (87) | 15 (25) 46 (75) | 3 (14) 19 (86) | 2 (40) 3 (60) | 3 (19) 13 (81) | 0.3 |
| JAK2 mutated; n (%) “N” evaluable = 144 | 98 (68) | 36 (71) | 37 (67) | 12 (75) | 4 (57) | 9 (60) | 0.8 |
| Allogeneic stem cell transplant; n (%) “N” evaluable = 228 | 24 (11) | 0 (0) | 0 (0) | 0 (0) | 8 (100) | 16 (100) | <0.0001 |
| Follow up in months; median (range) | 3.6 (0–122) | 1.6 (0–59.9) | 4.0 (0.2–70.7) | 8.7 (1.7–71.6) | 25.8 (7.9–122) | 22.6 (7.8–55) | <0.0001 |
| Deaths; n (%) | 239 (96) | 119 (98) | 79 (100) | 21 (88) | 7 (88) | 13 (81) | 0.0002 |
ANC absolute neutrophil count, AMC absolute monocyte count, JAK2 Janus kinase 2, CR complete remission, CRi CR with incomplete blood count recovery