{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T18:18:20Z","timestamp":1778782700580,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005010","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005010","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018202","name":"Artificial Intelligence Research Center","doi-asserted-by":"publisher","award":["21267"],"award-info":[{"award-number":["21267"]}],"id":[{"id":"10.13039\/100018202","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Prognostic modeling in myelofibrosis (MF) has classically pursued the integration of informative clinical and hematological parameters to separate patients' categories with different outcomes. Modern stratification includes also genetic data from karyotype and mutations. However, some poorly standardized variables, as peripheral blood (PB) blast count by morphology, are still included. In this study, we used multiparameter flow cytometry (MFC) with the aim of improving performance of existing scores. We studied 363 MF patients with available MFC files for PB CD34+ cells count determination at diagnosis. We adapted Ogata score to MF context including 2 parameters: absolute CD34+ cells count (\/\u03bcL) and granulocytes to lymphocytes SSC ratio. A score of 1 was attributed to above\u2010threshold values of each parameter. Accordingly, patients were categorized as MFC<jats:sub>low<\/jats:sub> (score\u00a0=\u00a00, 62.0%), MFC<jats:sub>int<\/jats:sub> (score\u00a0=\u00a01, 29.5%), and MFC<jats:sub>high<\/jats:sub> (score\u00a0=\u00a02, 8.5%). MFC<jats:sub>low<\/jats:sub> had significantly longer median OS (not reached) compared to MFC<jats:sub>int<\/jats:sub> (55\u2009months) and MFC<jats:sub>high<\/jats:sub> (19\u2009months). We integrated MFC into established models as a substitute of morphological PB blasts count. Patients were reclassified according to MFC\u2010enhanced scores, and concordance (C\u2010) indexes were compared. As regards IPSS, C\u2010indexes were 0.67 and 0.74 for standard and MFC\u2010enhanced model, respectively (Z score\u2009\u2212\u20093.82; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.0001). MFC\u2010enhanced MIPSS70+ model in PMF patients yielded a C\u2010index of 0.78, outperforming its standard counterpart (C\u2010index 0.73; Z score\u2009\u2212\u20092.88, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004). Our data suggest that the incorporation of MFC\u2010derived parameters, easily attainable from standard assay used for CD34+ cells determination, might help to refine the current prognostic stratification models in myelofibrosis.<\/jats:p>","DOI":"10.1002\/ajh.26548","type":"journal-article","created":{"date-parts":[[2022,3,26]],"date-time":"2022-03-26T12:19:00Z","timestamp":1648297140000},"page":"846-855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Integration of multiparameter flow cytometry score improves prognostic stratification provided by standard models in primary myelofibrosis"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-6501","authenticated-orcid":false,"given":"Francesco","family":"Mannelli","sequence":"first","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Bencini","sequence":"additional","affiliation":[{"name":"Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica Denothe Excellence Center  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Coltro","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6241-1206","authenticated-orcid":false,"given":"Giuseppe G.","family":"Loscocco","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"},{"name":"Doctorate School GenOMec University of Siena  Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Peruzzi","sequence":"additional","affiliation":[{"name":"Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica Denothe Excellence Center  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giada","family":"Rotunno","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Maccari","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Gesullo","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Borella","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Paoli","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Caporale","sequence":"additional","affiliation":[{"name":"Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica Denothe Excellence Center  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmela","family":"Mannarelli","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center Universit\u00e0 degli Studi  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Annunziato","sequence":"additional","affiliation":[{"name":"Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica Denothe Excellence Center  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Guglielmelli","sequence":"additional","affiliation":[{"name":"CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di 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