Risk stratification using DIPSS and splenomegaly in myelofibrosis treated with pre-transplant JAK inhibitors

Researchers compared the prognostic impact of the Dynamic International Prognostic Scoring System for primary myelofibrosis (DIPSS) between patients with myelofibrosis with and without pre-transplant ruxolitinib therapy. They found that DIPSS predicted transplant outcomes in patients with myelofibrosis who did not receive pre-transplant ruxolitinib, but not in those who did receive ruxolitinib prior to allogeneic transplant, presumably due to the impact of palpable splenomegaly. A proposed modified model, DIPSS with Splenomegaly (DIP3S), shows that the DIP3S high-risk diagnosis was independently associated with inferior overall survival, delayed neutrophil engraftment, and delayed platelet engraftment after transplant.