Systemic inflammatory indices for predicting prognosis of myelofibrosis

Ersal, Tuba; Özkocaman, Vildan; Pınar, İbrahim Ethem; Yalçın, Cumali; Orhan, Bedrettin; Candar, Ömer; Çubukçu, Sinem; Koca, Tuba Güllü; HUNUTLU, Fazıl Cagrı; Yavuz, Şeyma; Ali, Rıdvan; Özkalemkaş, Fahir

doi:10.1038/s41598-023-39077-7

Cited by 7 publications

(5 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the relationship between the SII and MPN has not been adequately investigated. Ersal et al evaluated the relationship between myelofibrosis and the SII but did not detect a significant relationship between the SII and mortality [18]. In the current study, we investigated the relationship between the SII and PV diagnosis.…”

Section: Discussionmentioning

confidence: 70%

“…It is well known that inflammation triggers all the stages of tumor growth, including initial genetic mutation, tumor development, metastasis, and progression [18]. Similarly, data show that chronic inflammation plays a critical role in the pathogenesis of MPN and that inflammatory conditions may lead to MPN-induced complications [23].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the platelet-to-lymphocyte ratio (PLR) was computed by dividing the absolute platelet count by the absolute lymphocyte count. The systemic immune-inflammation index (SII) was determined by multiplying the platelet count by the neutrophil count, which was then divided by the lymphocyte count [18,19].…”

Section: Laboratory Analysismentioning

confidence: 99%

See 2 more Smart Citations

The Systemic Inflammation Index: A New Candidate Minor Criterion in the Diagnosis of Polycythemia Vera

Gulturk,

Kapucu

2024

JPM

View full text Add to dashboard Cite

Aim: To investigate inflammation indices and erythropoietin levels for their potential role in distinguishing polycythemia vera from secondary polycythemia and to compare different parameter combinations in terms of the diagnostic accuracy. Methods: This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. Polycythemia vera diagnosis was made according to the 2016 World Health Organization criteria (n = 145). Those who did not fulfill the criteria were defined as having secondary polycythemia (n = 84). Results: The neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index were significantly higher in the polycythemia vera group (p < 0.001 for all). Erythropoietin had the highest area under the curve in the analysis to distinguish groups, followed by the systemic immune-inflammation index. The platelet lymphocyte ratio (≥135) had the highest specificity to detect polycythemia vera, followed closely by the systemic immune-inflammation index. The sensitivity for polycythemia vera detection was highest with the erythropoietin and systemic immune-inflammation index combination, followed by erythropoietin and the neutrophil lymphocyte ratio. All the single and combinatory variables exhibited significant performance in predicting polycythemia vera after adjusting for age and sex. However, the erythropoietin and systemic immune-inflammation index combination had the highest odds ratio, followed by erythropoietin alone. Conclusion: These are promising findings supporting the usability of these biomarkers, especially the systemic immune-inflammation index, as minor criteria in the diagnosis of polycythemia vera. It is especially crucial to note that using erythropoietin in combination with these markers may improve diagnostic accuracy.

show abstract

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Systemic Inflammation Index: A New Candidate Minor Criterion in the Diagnosis of Polycythemia Vera

Gulturk,

Kapucu

2024

JPM

View full text Add to dashboard Cite

show abstract

“…Furthermore, certain outcomes cannot be clearly delineated in nature. While cachexia is expectedly attributable to the investigated disease myelofibrosis in most cases, systemic inflammatory response syndrome can be directly caused by the disease or indirectly through a severe infection resulting from immunodeficiency [47]. The ICD code I80, which is part of the thrombosis definition in the present paper, also includes phlebitis; likewise, the outcome cachexia is not unambiguously defined, leading to potentially diverging assessment in the different HCOs.…”

Section: Discussionmentioning

confidence: 90%

Real-World Electronic Medical Records Data Identify Risk Factors for Myelofibrosis and Can Be Used to Validate Established Prognostic Scores

Kappenstein,

von Bubnoff

2024

Cancers

View full text Add to dashboard Cite

Myelofibrosis (MF) is a myeloproliferative neoplasia arising de novo as primary myelofibrosis (PMF) or secondary to polycythemia vera or essential thrombocythemia. Patients experience a high symptom burden and a marked reduction in life expectancy. Despite progress in molecular understanding and treatment, the clinical and prognostic heterogeneity of MF complicates treatment decisions. The International Prognostic Scoring System (IPSS) integrates clinical factors for risk stratification in MF. This study leverages the TriNetX database with more than 64,000 MF patients to assess the impact of accessible parameters on survival and complicating events, including AML transformation, cachexia, increased systemic inflammation, thrombosis and hemorrhage. Age over 65 years correlated with increased risks of death, AML transformation, thrombosis and hemorrhage. Anemia (Hb < 10 g/dL), leukocytosis (>25 × 103/µL) and thrombocytopenia (<150 × 103/µL) reduced survival and increased risks across all assessed events. Monocytosis is associated with decreased survival, whereas eosinophilia and basophilia were linked to improved survival. Further, as proof of concept for the applicability of TriNetX for clinical scores, we devised a simplified IPSS, and confirmed its value in predicting outcomes. This comprehensive study underscores the importance of age, anemia, leukocytosis and thrombocytopenia in predicting disease trajectory and contributes to refining prognostic models, addressing the challenges posed by the disease’s heterogeneity.

show abstract

“…It is undeniable that the current molecular genetic profiling results fall short of capturing all prognostically significant factors in MF. Beyond the IPSS, additional parameters such as spleen size and levels of lactate dehydrogenase (LDH) and ferritin [117] have been linked to the risk of disease progression and OS. Conversely, the Myelofibrosis Transplant Scoring System (MTSS, see Table 2), established to aid in selecting patients for HSCT, considers only the non-CALR/MPL driver mutation genotype and ASXL1 mutation as risk factors.…”

Section: Implications In the Prognosismentioning

confidence: 99%

Molecular Genetic Profile of Myelofibrosis: Implications in the Diagnosis, Prognosis, and Treatment Advancements

Verma,

Papadantonakis,

Peker Barclift

et al. 2024

Cancers

View full text Add to dashboard Cite

Myelofibrosis (MF) is an essential element of primary myelofibrosis, whereas secondary MF may develop in the advanced stages of other myeloid neoplasms, especially polycythemia vera and essential thrombocythemia. Over the last two decades, advances in molecular diagnostic techniques, particularly the integration of next-generation sequencing in clinical laboratories, have revolutionized the diagnosis, classification, and clinical decision making of myelofibrosis. Driver mutations involving JAK2, CALR, and MPL induce hyperactivity in the JAK-STAT signaling pathway, which plays a central role in cell survival and proliferation. Approximately 80% of myelofibrosis cases harbor additional mutations, frequently in the genes responsible for epigenetic regulation and RNA splicing. Detecting these mutations is crucial for diagnosing myeloproliferative neoplasms (MPNs), especially in cases where no mutations are present in the three driver genes (triple-negative MPNs). While fibrosis in the bone marrow results from the disturbance of inflammatory cytokines, it is fundamentally associated with mutation-driven hematopoiesis. The mutation profile and order of acquiring diverse mutations influence the MPN phenotype. Mutation profiling reveals clonal diversity in MF, offering insights into the clonal evolution of neoplastic progression. Prognostic prediction plays a pivotal role in guiding the treatment of myelofibrosis. Mutation profiles and cytogenetic abnormalities have been integrated into advanced prognostic scoring systems and personalized risk stratification for MF. Presently, JAK inhibitors are part of the standard of care for MF, with newer generations developed for enhanced efficacy and reduced adverse effects. However, only a minority of patients have achieved a significant molecular-level response. Clinical trials exploring innovative approaches, such as combining hypomethylation agents that target epigenetic regulators, drugs proven effective in myelodysplastic syndrome, or immune and inflammatory modulators with JAK inhibitors, have demonstrated promising results. These combinations may be more effective in patients with high-risk mutations and complex mutation profiles. Expanding mutation profiling studies with more sensitive and specific molecular methods, as well as sequencing a broader spectrum of genes in clinical patients, may reveal molecular mechanisms in cases currently lacking detectable driver mutations, provide a better understanding of the association between genetic alterations and clinical phenotypes, and offer valuable information to advance personalized treatment protocols to improve long-term survival and eradicate mutant clones with the hope of curing MF.

show abstract

Systemic inflammatory indices for predicting prognosis of myelofibrosis

Cited by 7 publications

References 35 publications

The Systemic Inflammation Index: A New Candidate Minor Criterion in the Diagnosis of Polycythemia Vera

The Systemic Inflammation Index: A New Candidate Minor Criterion in the Diagnosis of Polycythemia Vera

Real-World Electronic Medical Records Data Identify Risk Factors for Myelofibrosis and Can Be Used to Validate Established Prognostic Scores

Molecular Genetic Profile of Myelofibrosis: Implications in the Diagnosis, Prognosis, and Treatment Advancements

Contact Info

Product

Resources

About