Evolution in Prognostication in Myelofibrosis: From IPSS and DIPSS to MIPSS-70 and MYSEC-PM

Introduction In a disease with a wide heterogeneity of outcomes, risk-stratification systems play an important role in treatment decisionmaking and prognostication. Such is the case with Primary Myelofibrosis (PMF) as well as Post-ET/Post-PV Myelofibrosis (ET-MF, PV-MF). Over the last two decades, there has been a proliferation of research designed to help physicians and researchers discriminate among patients who have more indolent disease from those whose life-expectancy is considerably shorter and which merits more aggressive interventions.1 Novel systems take advantage of new technology, like next-generation sequencing. However, the most accurate systems require integration of validated patient data (which can be hard to obtain retrospectively), cytogenetic, genomic and treatment history. This can be a challenging undertaking.