Gender effect on phenotype and genotype in patients with post-polycythemia vera and post-essential thrombocythemia myelofibrosis: results from the MYSEC project

Myeloproliferative neoplasms (MPN) include essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF) and are established clonal disorders 1 . MPN diagnosis affects survival of individuals as compared with matched populations. Concerning PMF, survival is currently stratified on the basis of the International Prognostic Scoring System (IPSS) 2 and its variants or on the most recent mutation-based MIPSS-70 3 . In post-PV MF and post-ET MF, namely secondary myelofibrosis (SMF), the MYSEC PM (Myelofibrosis Secondary to PV and ET-Prognostic Model), has been recently developed to assess survival 4 . Epidemiological data have revealed an advantage for women in surviving a diagnosis of cancer compared with men 5 . Sex hormones might play a role in the hematopoiesis and in the pathogenesis of hematologic malignancies 6 . Concerning MPNs, gender differences have been observed in terms of disease distribution (higher prevalence of females in ET and of males in PV), JAK2V617F allele burden (lower in females) 7 , and numbers of homozygous mutant colonies (larger in males) 8 .