MDCalc

International Consensus Classification (ICC) Diagnostic Criteria for Primary Myelofibrosis (PMF)

Diagnoses primary myelofibrosis according to the International Consensus Classification (ICC).

Major Criteria (See Evidence for more details.)

Bone marrow biopsy showing megakaryocytic proliferation and atypia, bone marrow fibrosis grade <2, increased age-adjusted BM cellularity, granulocytic proliferation, and (often) decreased erythropoiesis

Bone marrow biopsy showing megakaryocytic proliferation and atypia, accompanied by reticulin and/or collagen fibrosis grades 2 or 3

JAK2, CALR, or MPL mutation or presence of another clonal marker 

Absence of reactive bone marrow reticulin fibrosis

Absence of reactive myelofibrosis

Diagnostic criteria for ET, PV, BCR::ABL1-positive CML, myelodysplastic syndrome, or other myeloid neoplasms are not met

Minor Criteria

Anemia not attributed to a comorbid condition

Leukocytosis ≥11 × 109/L

Palpable splenomegaly

Lactate dehydrogenase level above the reference range

Leukoerythroblastosis

Result:

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Advice
  • Use the results of this tool alongside clinical expertise and specialist consultations to finalize the diagnosis and classification of PMF.
  • Upon diagnosing PMF, perform risk stratification using a prognostic tool (e.g., IPSS, DIPSS, MIPSS, GIPSS) to guide management discussions and decisions.
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