ICC 2022 primary myelofibrosis criteria

ICC 2022 PMF criteria

Apply the Arber 2022 International Consensus Classification prefibrotic and overt primary myelofibrosis criteria and return whether all three majors and at least one applicable minor are met. Leukoerythroblastosis counts only for overt PMF.

LIVE $0.005 USDC GET /api/calc/icc_pmf

Markdown: /docs/icc-pmf.md · Canonical: https://magentlab.com/docs/icc-pmf

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

When to use

When an agent already has caller-assigned ICC 2022 PMF phenotype and major/minor flags and needs the published criteria result. magent does not diagnose PMF, does not read fibrosis grade, and does not sequence JAK2, CALR, or MPL.

When not to use

Not a medical device.
Not a diagnosis. Criteria met is not a primary myelofibrosis diagnosis without the rest of the ICC 2022 workup.
Not DIPSS, DIPSS Plus, MIPSS70, or MIPSS70-plus. This tool is ICC 2022 diagnostic criteria, not a prognostic score.
Not WHO 5th edition / Khoury 2022 classification.
Not post-PV or post-ET myelofibrosis. This tool is ICC 2022 primary myelofibrosis only (prefibrotic and overt).
magent does not read a biopsy or fibrosis grade. megakaryocyte_morphology is assigned by the caller for the chosen phenotype.
magent does not sequence JAK2, CALR, MPL, or other clonal markers. clonal_or_no_reactive is caller-assigned.

Formula

diagnosed iff three majors and minor_count ≥ 1; majors are megakaryocyte_morphology, not_other_myeloid, and clonal_or_no_reactive; minor_count is anemia_not_comorbid + leukocytosis_ge_11 + splenomegaly + ldh_above_uln + leukoerythroblastosis only when phenotype is overt (Arber 2022 ICC pre-PMF and overt PMF). Not DIPSS. Not WHO 5th. Not post-PV/post-ET myelofibrosis

Citation

Title: International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data
Authors: Arber DA, Orazi A, Hasserjian RP, Borowitz MJ, Calvo KR, Kvasnicka HM, Wang SA, Bagg A, Barbui T, Bennett JM, de la Fuente J, et al.
Source: Blood. 2022;140(11):1200-1228
DOI: 10.1182/blood.2022015850

Worked example

Prefibrotic PMF with anemia minor

Given: anemia_not_comorbid=trueclonal_or_no_reactive=trueldh_above_uln=falseleukocytosis_ge_11=falseleukoerythroblastosis=falsemegakaryocyte_morphology=truenot_other_myeloid=truephenotype=presplenomegaly=false

phenotype is pre; all three majors true → major_count 3
anemia_not_comorbid true; remaining shared minors false; leukoerythroblastosis false → minor_count 1
diagnosed true (three majors and at least one applicable minor)

Overt PMF with leukoerythroblastosis only

Given: anemia_not_comorbid=falseclonal_or_no_reactive=trueldh_above_uln=falseleukocytosis_ge_11=falseleukoerythroblastosis=truemegakaryocyte_morphology=truenot_other_myeloid=truephenotype=overtsplenomegaly=false

phenotype is overt; all three majors true → major_count 3
shared minors false; leukoerythroblastosis true → minor_count 1 (overt minor)
diagnosed true

Three majors without a counted minor

Given: anemia_not_comorbid=falseclonal_or_no_reactive=trueldh_above_uln=falseleukocytosis_ge_11=falseleukoerythroblastosis=falsemegakaryocyte_morphology=truenot_other_myeloid=truephenotype=presplenomegaly=false

phenotype is pre; all three majors true → major_count 3
all minors false → minor_count 0
diagnosed false (need at least one applicable minor)

Prefibrotic PMF ignores leukoerythroblastosis

phenotype is pre; all three majors true → major_count 3
leukoerythroblastosis true is echoed but does not count; shared minors false → minor_count 0
diagnosed false (ICC: leukoerythroblastosis is an overt-PMF minor)

Also searched as

ICC 2022 primary myelofibrosis
prefibrotic PMF diagnostic criteria
overt PMF ICC 2022
Arber 2022 myeloid neoplasms PMF
pre-PMF megakaryocyte atypia
JAK2 CALR MPL primary myelofibrosis
ICC prefibrotic versus overt PMF
reticulin fibrosis grade 2 PMF

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/icc_pmf?phenotype=pre&megakaryocyte_morphology=true&not_other_myeloid=true&clonal_or_no_reactive=true&anemia_not_comorbid=true&leukocytosis_ge_11=false&splenomegaly=false&ldh_above_uln=false&leukoerythroblastosis=false

Full URL: https://api.magentlab.com/api/calc/icc_pmf?phenotype=pre&megakaryocyte_morphology=true&not_other_myeloid=true&clonal_or_no_reactive=true&anemia_not_comorbid=true&leukocytosis_ge_11=false&splenomegaly=false&ldh_above_uln=false&leukoerythroblastosis=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/icc_pmf?phenotype=pre&megakaryocyte_morphology=true&not_other_myeloid=true&clonal_or_no_reactive=true&anemia_not_comorbid=true&leukocytosis_ge_11=false&splenomegaly=false&ldh_above_uln=false&leukoerythroblastosis=false"

Parameters

Name	Type	Required	Description
`phenotype`	string	required · pre, overt	pre (prefibrotic/early PMF) or overt (overt fibrotic PMF) as assigned by the caller (Arber 2022 ICC). Required. magent does not assign phenotype from a biopsy.
`megakaryocyte_morphology`	boolean	required	Megakaryocytic proliferation and atypia for the chosen phenotype, as assigned by the caller (Arber 2022 ICC PMF major). For pre: without reticulin fibrosis grade >1, with increased age-adjusted cellularity, granulocytic proliferation, and often decreased erythropoiesis. For overt: accompanied by reticulin and/or collagen fibrosis grade 2 or 3. true or false. magent does not read a biopsy.
`not_other_myeloid`	boolean	required	Does not meet ICC/WHO criteria for BCR::ABL1-positive CML, PV, ET, MDS, or another defined myeloid neoplasm, as assigned by the caller (Arber 2022 ICC PMF major). true or false. magent does not diagnose those neoplasms.
`clonal_or_no_reactive`	boolean	required	JAK2, CALR, or MPL mutation, or another clonal marker, or absence of reactive bone-marrow fibrosis, as assigned by the caller (Arber 2022 ICC PMF major). true or false. magent does not sequence.
`anemia_not_comorbid`	boolean	required	Anemia not attributed to a comorbid condition, as assigned by the caller (Arber 2022 ICC PMF minor). true or false. magent does not assay hemoglobin.
`leukocytosis_ge_11`	boolean	required	Leukocytosis ≥11 × 10^9/L as assigned by the caller (Arber 2022 ICC PMF minor). true or false. magent does not assay WBC.
`splenomegaly`	boolean	required	Palpable splenomegaly as assigned by the caller (Arber 2022 ICC PMF minor). true or false. magent does not examine the spleen.
`ldh_above_uln`	boolean	required	LDH above the institutional upper limit of normal as assigned by the caller (Arber 2022 ICC PMF minor). true or false. magent does not assay LDH.
`leukoerythroblastosis`	boolean	required	Leukoerythroblastosis as assigned by the caller (Arber 2022 ICC overt-PMF minor). Counts toward minor_count only when phenotype is overt; echoed but not counted when phenotype is pre. true or false. magent does not read a smear.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/icc_pmf Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "anemia_not_comorbid": "true",
      "clonal_or_no_reactive": "true",
      "ldh_above_uln": "false",
      "leukocytosis_ge_11": "false",
      "leukoerythroblastosis": "false",
      "megakaryocyte_morphology": "true",
      "not_other_myeloid": "true",
      "phenotype": "pre",
      "splenomegaly": "false"
    },
    {
      "anemia_not_comorbid": "true",
      "clonal_or_no_reactive": "true",
      "ldh_above_uln": "false",
      "leukocytosis_ge_11": "false",
      "leukoerythroblastosis": "false",
      "megakaryocyte_morphology": "true",
      "not_other_myeloid": "true",
      "phenotype": "pre",
      "splenomegaly": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/icc_pmf",
  "items": [
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Arber DA, Orazi A, Hasserjian RP, Borowitz MJ, Calvo KR, Kvasnicka HM, Wang SA, Bagg A, Barbui T, Bennett JM, de la Fuente J, et al.",
        "doi": "10.1182/blood.2022015850",
        "id": "arber-2022",
        "pmid": "35767897",
        "source": "Blood. 2022;140(11):1200-1228",
        "title": "International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data"
      },
      "formula": "icc_pmf",
      "formula_expression": "diagnosed iff three majors and minor_count ≥ 1; majors are megakaryocyte_morphology, not_other_myeloid, and clonal_or_no_reactive; minor_count is anemia_not_comorbid + leukocytosis_ge_11 + splenomegaly + ldh_above_uln + leukoerythroblastosis only when phenotype is overt (Arber 2022 ICC pre-PMF and overt PMF). Not DIPSS. Not WHO 5th. Not post-PV/post-ET myelofibrosis",
      "criteria": [
        {
          "factor": "megakaryocyte_morphology",
          "met": true
        },
        {
          "factor": "not_other_myeloid",
          "met": true
        },
        {
          "factor": "clonal_or_no_reactive",
          "met": true
        },
        {
          "factor": "anemia_not_comorbid",
          "met": true
        },
        {
          "factor": "leukocytosis_ge_11",
          "met": false
        },
        {
          "factor": "splenomegaly",
          "met": false
        },
        {
          "factor": "ldh_above_uln",
          "met": false
        },
        {
          "factor": "leukoerythroblastosis",
          "met": false
        },
        {
          "factor": "three_majors",
          "met": true
        },
        {
          "factor": "minor_count_ge_1",
          "met": true
        }
      ],
      "major_count": 3,
      "minor_count": 1,
      "phenotype": "pre",
      "anemia_not_comorbid": true,
      "clonal_or_no_reactive": true,
      "diagnosed": true,
      "ldh_above_uln": false,
      "leukocytosis_ge_11": false,
      "leukoerythroblastosis": false,
      "megakaryocyte_morphology": true,
      "not_other_myeloid": true,
      "splenomegaly": false
    },
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Arber DA, Orazi A, Hasserjian RP, Borowitz MJ, Calvo KR, Kvasnicka HM, Wang SA, Bagg A, Barbui T, Bennett JM, de la Fuente J, et al.",
        "doi": "10.1182/blood.2022015850",
        "id": "arber-2022",
        "pmid": "35767897",
        "source": "Blood. 2022;140(11):1200-1228",
        "title": "International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data"
      },
      "formula": "icc_pmf",
      "formula_expression": "diagnosed iff three majors and minor_count ≥ 1; majors are megakaryocyte_morphology, not_other_myeloid, and clonal_or_no_reactive; minor_count is anemia_not_comorbid + leukocytosis_ge_11 + splenomegaly + ldh_above_uln + leukoerythroblastosis only when phenotype is overt (Arber 2022 ICC pre-PMF and overt PMF). Not DIPSS. Not WHO 5th. Not post-PV/post-ET myelofibrosis",
      "criteria": [
        {
          "factor": "megakaryocyte_morphology",
          "met": true
        },
        {
          "factor": "not_other_myeloid",
          "met": true
        },
        {
          "factor": "clonal_or_no_reactive",
          "met": true
        },
        {
          "factor": "anemia_not_comorbid",
          "met": true
        },
        {
          "factor": "leukocytosis_ge_11",
          "met": false
        },
        {
          "factor": "splenomegaly",
          "met": false
        },
        {
          "factor": "ldh_above_uln",
          "met": false
        },
        {
          "factor": "leukoerythroblastosis",
          "met": false
        },
        {
          "factor": "three_majors",
          "met": true
        },
        {
          "factor": "minor_count_ge_1",
          "met": true
        }
      ],
      "major_count": 3,
      "minor_count": 1,
      "phenotype": "pre",
      "anemia_not_comorbid": true,
      "clonal_or_no_reactive": true,
      "diagnosed": true,
      "ldh_above_uln": false,
      "leukocytosis_ge_11": false,
      "leukoerythroblastosis": false,
      "megakaryocyte_morphology": true,
      "not_other_myeloid": true,
      "splenomegaly": false
    }
  ]
}

Response

Field	Type	Description
`formula`	string	icc_pmf
`formula_expression`	string	Arber 2022 ICC pre-PMF and overt PMF major/minor combination
`phenotype`	string	pre or overt used
`diagnosed`	boolean	true iff all three majors and minor_count ≥ 1. Not a diagnosis. Not DIPSS. Not WHO 5th / Khoury. Not post-PV/post-ET myelofibrosis.
`major_count`	integer	Count of megakaryocyte_morphology, not_other_myeloid, and clonal_or_no_reactive that are true
`minor_count`	integer	Count of anemia_not_comorbid, leukocytosis_ge_11, splenomegaly, and ldh_above_uln that are true, plus leukoerythroblastosis only when phenotype is overt
`megakaryocyte_morphology`	boolean	Caller-assigned megakaryocyte morphology major for the chosen phenotype
`not_other_myeloid`	boolean	Caller-assigned not-another-defined-myeloid-neoplasm major used
`clonal_or_no_reactive`	boolean	Caller-assigned clonal marker or no reactive fibrosis major used
`anemia_not_comorbid`	boolean	Caller-assigned anemia-not-from-comorbidity minor used
`leukocytosis_ge_11`	boolean	Caller-assigned leukocytosis ≥11 × 10^9/L minor used
`splenomegaly`	boolean	Caller-assigned palpable splenomegaly minor used
`ldh_above_uln`	boolean	Caller-assigned LDH above ULN minor used
`leukoerythroblastosis`	boolean	Caller-assigned leukoerythroblastosis flag echoed; counted as a minor only when phenotype is overt
`criteria`	array	Per-factor rows with factor and met for the three majors, four shared minors, leukoerythroblastosis, three_majors, and minor_count_ge_1
`citation`	object	Arber 2022 Blood ICC PMF citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Arber DA, Orazi A, Hasserjian RP, Borowitz MJ, Calvo KR, Kvasnicka HM, Wang SA, Bagg A, Barbui T, Bennett JM, de la Fuente J, et al.",
    "doi": "10.1182/blood.2022015850",
    "id": "arber-2022",
    "pmid": "35767897",
    "source": "Blood. 2022;140(11):1200-1228",
    "title": "International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data"
  },
  "formula": "icc_pmf",
  "formula_expression": "diagnosed iff three majors and minor_count ≥ 1; majors are megakaryocyte_morphology, not_other_myeloid, and clonal_or_no_reactive; minor_count is anemia_not_comorbid + leukocytosis_ge_11 + splenomegaly + ldh_above_uln + leukoerythroblastosis only when phenotype is overt (Arber 2022 ICC pre-PMF and overt PMF). Not DIPSS. Not WHO 5th. Not post-PV/post-ET myelofibrosis",
  "criteria": [
    {
      "factor": "megakaryocyte_morphology",
      "met": true
    },
    {
      "factor": "not_other_myeloid",
      "met": true
    },
    {
      "factor": "clonal_or_no_reactive",
      "met": true
    },
    {
      "factor": "anemia_not_comorbid",
      "met": true
    },
    {
      "factor": "leukocytosis_ge_11",
      "met": false
    },
    {
      "factor": "splenomegaly",
      "met": false
    },
    {
      "factor": "ldh_above_uln",
      "met": false
    },
    {
      "factor": "leukoerythroblastosis",
      "met": false
    },
    {
      "factor": "three_majors",
      "met": true
    },
    {
      "factor": "minor_count_ge_1",
      "met": true
    }
  ],
  "major_count": 3,
  "minor_count": 1,
  "phenotype": "pre",
  "anemia_not_comorbid": true,
  "clonal_or_no_reactive": true,
  "diagnosed": true,
  "ldh_above_uln": false,
  "leukocytosis_ge_11": false,
  "leukoerythroblastosis": false,
  "megakaryocyte_morphology": true,
  "not_other_myeloid": true,
  "splenomegaly": false
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_pmf_phenotype`	phenotype must be pre or overt (Arber 2022 ICC prefibrotic versus overt primary myelofibrosis). Returned before settlement; you are not charged.
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

DIPSS — Sum the Passamonti 2010 DIPSS (dynamic international prognostic scoring system) for primary myelofibrosis and return low (0), intermediate_1 (1–2), intermediate_2 (3–4), or high (5–6).
GIPSS — Sum the Tefferi 2018 GIPSS (genetically inspired prognostic scoring system) for primary myelofibrosis and return low (0), intermediate_1 (1), intermediate_2 (2), or high (≥3).

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.