{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T02:34:50Z","timestamp":1773023690412,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T00:00:00Z","timestamp":1489968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The 2016 World Health Organization (WHO) diagnostic criteria for myeloproliferative neoplasms (MPN) underscore the prognostically\u2010relevant distinction between essential thrombocythemia (ET) and prefibrotic primary myelofibrosis (pre\u2010PMF). In addition, leukocytosis has been identified as an important prognostic marker in otherwise WHO\u2010defined ET. However, controversy remains regarding the objectivity of morphologic criteria in distinguishing ET from pre\u2010PMF and the precise prognostic cutoff values for leukocytosis. Serum lactate dehydrogenase (LDH) level might be a biologically more accurate measure of leukocyte turnover and a more sensitive marker of pre\u2010PMF, in otherwise WHO\u2010defined ET. In the current study of 183 consecutive patients with WHO\u2010defined ET, the presence of grade 1 bone marrow (BM) fibrosis did not affect presenting clinical or laboratory features; in contrast, increased serum LDH at diagnosis was associated with leukocytosis (<jats:italic>p<\/jats:italic>\u2009=\u2009.002), thrombocytosis (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), palpable splenomegaly (<jats:italic>p<\/jats:italic>\u2009=\u2009.03) and higher international prognostic score (IPSET) (<jats:italic>p<\/jats:italic>\u2009=\u2009.002); serum LDH did not correlate with BM fibrosis, <jats:italic>JAK2<\/jats:italic>\/<jats:italic>CALR<\/jats:italic>\/<jats:italic>MPL<\/jats:italic> or <jats:italic>TET2\/ASXL1<\/jats:italic> mutations. In univariate analysis, risk factors for survival included age \u226560 years (<jats:italic>p<\/jats:italic>\u2009=\u2009.002; HR 10.2, 95% CI 2.3\u201044.6), male sex (<jats:italic>p<\/jats:italic>\u2009=\u2009.02; HR 3.2, 95% CI 1.2\u20108.2), leukocyte count \u226515 \u00d7 10<jats:sup>9<\/jats:sup>\/L (<jats:italic>p<\/jats:italic>\u2009=\u2009.007; HR 4.7, 95% CI 1.5\u201014.6), and increased serum LDH (<jats:italic>p<\/jats:italic>\u2009=\u2009.002; HR 3.7, 95% CI 1.5\u20109.1), but not BM fibrosis (<jats:italic>p<\/jats:italic>\u2009=\u2009.17). In multivariable analysis, age, sex and serum LDH remained significant; serum LDH also remained significant, in the context of IPSET (<jats:italic>p<\/jats:italic>\u2009=\u2009.003) and in patients with leukocytosis (<jats:italic>p<\/jats:italic>\u2009=\u2009.003). We conclude that serum LDH level carries an independent prognostic value for survival in ET and might represent a biologically more accurate surrogate for leukocytosis.<\/jats:p>","DOI":"10.1002\/ajh.24689","type":"journal-article","created":{"date-parts":[[2017,2,17]],"date-time":"2017-02-17T08:26:36Z","timestamp":1487319996000},"page":"454-459","source":"Crossref","is-referenced-by-count":13,"title":["The prognostic relevance of serum lactate dehydrogenase and mild bone marrow reticulin fibrosis in essential thrombocythemia"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0550-8933","authenticated-orcid":false,"given":"Mythri","family":"Mudireddy","sequence":"first","affiliation":[{"name":"Division of Hematology Department of Internal Medicine, Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Barraco","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Internal Medicine, Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis A.","family":"Hanson","sequence":"additional","affiliation":[{"name":"Division of Hematopathology Department of Laboratory Medicine, Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Animesh","family":"Pardanani","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Internal Medicine, Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naseema","family":"Gangat","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Internal Medicine, Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayalew","family":"Tefferi","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Internal Medicine, Mayo Clinic Rochester 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