Validation and interpretation of the Triple A model in Turkish myeloproliferative neoplasm patients with a focus on overall and thrombosis free survival

Abstract

Background: The Triple A model has recently been developed and validated in essential thrombocythemia (ET) and polycythemia vera (PV). However, external validation in diverse populations remains unclear. Purpose: The purpose of this study was to externally validate the Triple A prognostic model in a Turkish cohort of patients with ET and PV. Methods: A retrospective analysis was conducted at two centers in Bursa, Türkiye, involving patients diagnosed with ET or PV under the World Health Organization (WHO) 2016/2022 criteria between 2014 and 2024. Results: While the Triple A model has significantly separated the ET patients with a median follow-up of 47 months (p = 0.015), no significant difference was observed in PV patients in terms of survival (p = 0.87). For thrombosis-free survival (TFS), Fine and Gray’s competing risk analysis showed a significant separation with the Triple A model in ET (p = 0.017). Conclusion: While the Triple A model was validated as a practical prognostic tool in ET, it demonstrated limited utility in PV. Further multicenter studies are needed to refine risk stratification in PV.