TY - JOUR
T1 - Prediction of thrombosis in post-polycythemia vera and post-essential thrombocythemia myelofibrosis
T2 - a study on 1258 patients
AU - Mora, Barbara
AU - Guglielmelli, Paola
AU - Kuykendall, Andrew
AU - Rumi, Elisa
AU - Maffioli, Margherita
AU - Palandri, Francesca
AU - De Stefano, Valerio
AU - Caramella, Marianna
AU - Salmoiraghi, Silvia
AU - Kiladjian, Jean Jacques
AU - Gotlib, Jason
AU - Iurlo, Alessandra
AU - Cervantes, Francisco
AU - Ruggeri, Marco
AU - Silver, Richard T.
AU - Albano, Francesco
AU - Benevolo, Giulia
AU - Ross, David M.
AU - Della Porta, Matteo G.
AU - Devos, Timothy
AU - Rotunno, Giada
AU - Komrokji, Rami S.
AU - Casetti, Ilaria C.
AU - Merli, Michele
AU - Brociner, Marco
AU - Caramazza, Domenica
AU - Auteri, Giuseppe
AU - Barbui, Tiziano
AU - Cattaneo, Daniele
AU - Bertù, Lorenza
AU - Arcaini, Luca
AU - Vannucchi, Alessandro M.
AU - Passamonti, Francesco
PY - 2022/10
Y1 - 2022/10
N2 - Patients with Philadelphia-negative myeloproliferative neoplasms are at high risk of thrombotic events (TEs). Predisposing factors have been identified in essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (primary MF, PMF), while yet not recognized in post PV/ET-MF (known as secondary MF, SMF). Within the 1258 SMF of the MYSEC (MYelofibrosis SECondary to PV and ET) dataset, 135 (10.7%) developed a TE at a median follow-up of 3.5 years (range, 1–21.4), with an incidence of 2.3% patients per year. Venous events accounted for two-thirds of the total. Cox multivariable analysis, supported by Fine-Gray models with death as competitive risk, showed that being on cytoreductive therapy at time of SMF evolution is associated with an absolute risk reduction of thrombosis equal to 3.3% within 3 years. Considering individually cytoreductive therapies, univariate regression model found that both conventional cytoreduction, mainly hydroxyurea, (HR 0.41, 95% CI: 0.26–0.65, p = 0.0001) and JAK inhibitors, mostly ruxolitinib, (HR 0.50, 95% CI: 0.24–1.02, p = 0.05) were associated with fewer thrombosis. Our study informs treating physicians of a non-low incidence of TEs in post PV/ET-MF and of the potential protective role of cytoreductive therapy in terms of thrombotic events.
AB - Patients with Philadelphia-negative myeloproliferative neoplasms are at high risk of thrombotic events (TEs). Predisposing factors have been identified in essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (primary MF, PMF), while yet not recognized in post PV/ET-MF (known as secondary MF, SMF). Within the 1258 SMF of the MYSEC (MYelofibrosis SECondary to PV and ET) dataset, 135 (10.7%) developed a TE at a median follow-up of 3.5 years (range, 1–21.4), with an incidence of 2.3% patients per year. Venous events accounted for two-thirds of the total. Cox multivariable analysis, supported by Fine-Gray models with death as competitive risk, showed that being on cytoreductive therapy at time of SMF evolution is associated with an absolute risk reduction of thrombosis equal to 3.3% within 3 years. Considering individually cytoreductive therapies, univariate regression model found that both conventional cytoreduction, mainly hydroxyurea, (HR 0.41, 95% CI: 0.26–0.65, p = 0.0001) and JAK inhibitors, mostly ruxolitinib, (HR 0.50, 95% CI: 0.24–1.02, p = 0.05) were associated with fewer thrombosis. Our study informs treating physicians of a non-low incidence of TEs in post PV/ET-MF and of the potential protective role of cytoreductive therapy in terms of thrombotic events.
KW - Myeloproliferative disease
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85137105030&partnerID=8YFLogxK
U2 - 10.1038/s41375-022-01673-3
DO - 10.1038/s41375-022-01673-3
M3 - Article
C2 - 36042316
AN - SCOPUS:85137105030
SN - 0887-6924
VL - 36
SP - 2453
EP - 2460
JO - Leukemia
JF - Leukemia
IS - 10
ER -