Patterns of Care for Older Patients With Myelofibrosis: A Population-based Study

Meckstroth, Shelby; Wang, Rong; Ma, Xiaomei; Podoltsev, Nikolai A.

doi:10.1016/j.clml.2021.01.025

Cited by 6 publications

(1 citation statement)

References 18 publications

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“…Anemia had a significant impact on both survival and the likelihood of MF-associated complications. Advanced age solely affected survival and, to a lesser degree, the likelihood for progression to AML as well as hemorrhage and thrombosis, but not the other examined secondary events, suggesting that reduced life expectancy can at least partially be attributed to the physiological aging process and, in addition, might be related to the limited treatment options available for older individuals [32], which is reflected in this study by a significantly lower rate of allogeneic stem cell transplantations compared to younger individuals. Leukocytosis significantly affected survival and AML transformation, not the other assessed secondary events, which could be attributable to the relatively low number of patients included after propensity score matching (232 patients for each of the two cohorts).…”

Section: Discussionmentioning

confidence: 61%

Real-World Electronic Medical Records Data Identify Risk Factors for Myelofibrosis and Can Be Used to Validate Established Prognostic Scores

Kappenstein,

von Bubnoff

2024

Cancers

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Myelofibrosis (MF) is a myeloproliferative neoplasia arising de novo as primary myelofibrosis (PMF) or secondary to polycythemia vera or essential thrombocythemia. Patients experience a high symptom burden and a marked reduction in life expectancy. Despite progress in molecular understanding and treatment, the clinical and prognostic heterogeneity of MF complicates treatment decisions. The International Prognostic Scoring System (IPSS) integrates clinical factors for risk stratification in MF. This study leverages the TriNetX database with more than 64,000 MF patients to assess the impact of accessible parameters on survival and complicating events, including AML transformation, cachexia, increased systemic inflammation, thrombosis and hemorrhage. Age over 65 years correlated with increased risks of death, AML transformation, thrombosis and hemorrhage. Anemia (Hb < 10 g/dL), leukocytosis (>25 × 103/µL) and thrombocytopenia (<150 × 103/µL) reduced survival and increased risks across all assessed events. Monocytosis is associated with decreased survival, whereas eosinophilia and basophilia were linked to improved survival. Further, as proof of concept for the applicability of TriNetX for clinical scores, we devised a simplified IPSS, and confirmed its value in predicting outcomes. This comprehensive study underscores the importance of age, anemia, leukocytosis and thrombocytopenia in predicting disease trajectory and contributes to refining prognostic models, addressing the challenges posed by the disease’s heterogeneity.

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Section: Discussionmentioning

confidence: 61%

Real-World Electronic Medical Records Data Identify Risk Factors for Myelofibrosis and Can Be Used to Validate Established Prognostic Scores

Kappenstein,

von Bubnoff

2024

Cancers

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Improved survival of patients with myelofibrosis in the last decade: Single‐center experience

Masárová

Bose

Pemmaraju

et al. 2022

Cancer

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BACKGROUND:The management of myelofibrosis (MF) has changed over the last several years and could have an impact on patient outcome. This study evaluates the survival of patients with MF at the authors' institution to determine whether it changed in the last decade. METHODS: This retrospective study consists of 844 patients (64% male; median age, 66 years; range, 20-90 years) who were examined between 2000 and 2020 with a new diagnosis of MF. Only patients with available marrow biopsy who had reticulin fibrosis of grade 2 or higher were included. Patients were compared by year of presentation: 2000-2010 (n = 373) and 2011-2020 (n = 471). RESULTS: A statistically significant improvement in median survival in the last decade was noted: from 48 months (95% CI, 42-54 months) to 63 months (95% CI, 55-71 months) (P < .001; HR, 0.78 [95% CI, 0.64-0.95]). Improved survival was observed also in patients 65 years old or older and those having intermediate 2 or high-risk Dynamic International Prognostic Scoring System (DIPSS) or DIPSS-Plus risk scores. Among 532 patients treated with MF-directed therapy, patients exposed to JAK inhibitor ruxolitinib had superior outcomes with median overall survival of 84 months (95% CI, 70-94 months). CONCLUSIONS: The results demonstrate that survival of patients with MF has improved in the last decade. This improvement is likely due to increased disease awareness, advances in supportive care, and the development of effective treatments.

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Considerations to comprehensive care for the older individual with myelofibrosis

McLornan

Saunders

Harrison

2022

Best Practice & Research Clinical Haematology

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Patterns of Care for Older Patients With Myelofibrosis: A Population-based Study

Cited by 6 publications

References 18 publications

Real-World Electronic Medical Records Data Identify Risk Factors for Myelofibrosis and Can Be Used to Validate Established Prognostic Scores

Real-World Electronic Medical Records Data Identify Risk Factors for Myelofibrosis and Can Be Used to Validate Established Prognostic Scores

Improved survival of patients with myelofibrosis in the last decade: Single‐center experience

Considerations to comprehensive care for the older individual with myelofibrosis

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