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World J Hematol. Aug 6, 2014; 3(3): 85-92
Published online Aug 6, 2014. doi: 10.5315/wjh.v3.i3.85
Myelofibrosis: Prognostication and cytoreductive treatment
Margherita Maffioli, Domenica Caramazza, Barbara Mora, Michele Merli, Francesco Passamonti
Margherita Maffioli, Domenica Caramazza, Barbara Mora, Michele Merli, Francesco Passamonti, Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy
Author contributions: Maffioli M and Passamonti F wrote the paper; Maffioli M, Caramazza D, Mora B, Merli M and Passamonti F discussed the mail topics of the paper and all gave the final approval of the manuscript.
Correspondence to: Francesco Passamonti, MD, Division of Hematology, Department of Medicine, University Hospital Ospedale di Circolo e Fondazione Macchi, Viale L. Borri 57, 21100 Varese, Italy. francesco.passamonti@ospedale.varese.it
Telephone: +39-332-393648 Fax: +39-332-393648
Received: November 2, 2013
Revised: February 8, 2014
Accepted: June 10, 2014
Published online: August 6, 2014
Processing time: 351 Days and 18.1 Hours
Core Tip

Core tip: Myelofibrosis (MF) is a mutational/clinical-complex disease. Prognostication of MF is based on the International Prognostic scoring system (IPSS) model at diagnosis and on the Dynamic IPSS thereafter. Factors included in both models are: age > 65 years, constitutional symptoms, hemoglobin < 10 g/dL, leukocytes > 25 × 109/L, and circulating blast cells 1% or greater. Cytogenetic profile and mutational status help to better discriminate within each IPSS category. JAK inhibitors are new promising therapies with a molecular target, translating into a clinical benefit: spleen reduction MF-symptoms refief. Among JAK inhibitor, ruxolitinib has been approved for MF.