Blood tests may predict early primary myelofibrosis in patients presenting with essential thrombocythemia

Alessandra Carobbio, Guido Finazzi, Juergen Thiele, Hans Michael Kvasnicka, Francesco Passamonti, Elisa Rumi, Marco Ruggeri, Francesco Rodeghiero, Maria Luigia Randi, Irene Bertozzi, Alessandro M. Vannucchi, Elisabetta Antonioli, Heinz Gisslinger, Veronika Buxhofer-Ausch, Naseema Gangat, Alessandro Rambaldi, Ayalew Tefferi, Tiziano Barbui

Research output: Contribution to journalLetterpeer-review

20 Scopus citations


According to World Health Organization (WHO)-defined criteria, patients presenting clinically as essential thrombocythemia (ET) may show early primary myelofibrosis (PMF) with accompanying thrombocythemia. Previous clinicopathological studies revealed that laboratory parameters like gender-matched hemoglobin (Hb), white blood cell (WBC) count, and particularly lactate dehydrogenase (LDH) values are significantly different in PMF. By strictly applying the WHO criteria, our investigation was aimed to study sensitivity and specificity of these features in an exploratory cohort of 536 patients and to validate the results on an independently recruited series of 321 strictly corresponding patients. The discriminatory power of these parameters (Hb, WBC, and LDH) was tested by plotting their receiver operating characteristic curves. The best performance was found for LDH (areas under the curve, AUC = 0.7059). WBC and Hb had superimposable curves, with AUC of 0.6279 and 0.6257, respectively. A diagnostic algorithm was generated by applying these parameters in a stepwise fashion. Nearly half of the patients could be correctly allocated to WHO-defined ET or early PMF in both cohorts investigated. It is important to note that this result does not substitute bone marrow morphology with hematological parameters, however, in clinical practice may alert physicians to get more suspicious of early PMF in a patient presumably presenting with ET.

Original languageEnglish (US)
Pages (from-to)203-204
Number of pages2
JournalAmerican journal of hematology
Issue number2
StatePublished - Feb 2012

ASJC Scopus subject areas

  • Hematology


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