TY - JOUR
T1 - 3023 Mayo Clinic Patients With Myeloproliferative Neoplasms
T2 - Risk-Stratified Comparison of Survival and Outcomes Data Among Disease Subgroups
AU - Szuber, Natasha
AU - Mudireddy, Mythri
AU - Nicolosi, Maura
AU - Penna, Domenico
AU - Vallapureddy, Rangit R.
AU - Lasho, Terra L.
AU - Finke, Christy
AU - Begna, Kebede H.
AU - Elliott, Michelle A.
AU - Hook, C. Christopher
AU - Wolanskyj, Alexandra P.
AU - Patnaik, Mrinal M.
AU - Hanson, Curtis A.
AU - Ketterling, Rhett P.
AU - Sirhan, Shireen
AU - Pardanani, Animesh
AU - Gangat, Naseema
AU - Busque, Lambert
AU - Tefferi, Ayalew
N1 - Publisher Copyright:
© 2018 Mayo Foundation for Medical Education and Research
PY - 2019/4
Y1 - 2019/4
N2 - Objective: To document the Mayo Clinic decades-long experience with myeloproliferative neoplasms (MPNs) and provide mature risk-stratified survival data and disease complication estimates. Patients and Methods: All Mayo Clinic patients with World Health Organization–defined MPNs constituted the core study group and included those with polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). Results: A total of 3023 consecutive patients (median age, 62 years; range, 18-96 years) were considered: 665 PV, 1076 ET, and 1282 PMF. From October 27, 1967, through December 29, 2017, 1631 deaths (54%), 183 leukemic transformations (6%), 244 fibrotic progressions (14%), and 516 thrombotic events (17%) were recorded. Median overall survival (OS) was 18 years for ET, 15 years for PV, and 4.4 years for PMF (P<.05 for all intergroup comparisons). Inferior survival was documented in patients with ET diagnosed more recently (post-1990) (P<.001), whereas survival data were time independent in PV and PMF. After conventional risk stratification, OS in low-risk ET and low-risk PV were superimposed (P=.89) but each differed significantly from that of age- and sex-matched controls (P<.001). Leukemia-free survival was similar for ET and PV (P=.22) and significantly worse with PMF (P<.001). Compared with ET, PV was associated with higher risk of fibrotic progression (P<.001). Thrombosis risk after diagnosis was highest in PV and lowest in PMF (P=.002 for PV vs ET; P=.56 for ET vs PMF; and P=.001 for PV vs PMF). Conclusion: This study provides the most mature survival and outcomes data in MPNs and highlights MPN subgroup risk categorization as key in appraising disease natural history. The OS was only marginally better in ET compared with PV, and PV displayed a higher risk of thrombosis and fibrotic progression.
AB - Objective: To document the Mayo Clinic decades-long experience with myeloproliferative neoplasms (MPNs) and provide mature risk-stratified survival data and disease complication estimates. Patients and Methods: All Mayo Clinic patients with World Health Organization–defined MPNs constituted the core study group and included those with polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). Results: A total of 3023 consecutive patients (median age, 62 years; range, 18-96 years) were considered: 665 PV, 1076 ET, and 1282 PMF. From October 27, 1967, through December 29, 2017, 1631 deaths (54%), 183 leukemic transformations (6%), 244 fibrotic progressions (14%), and 516 thrombotic events (17%) were recorded. Median overall survival (OS) was 18 years for ET, 15 years for PV, and 4.4 years for PMF (P<.05 for all intergroup comparisons). Inferior survival was documented in patients with ET diagnosed more recently (post-1990) (P<.001), whereas survival data were time independent in PV and PMF. After conventional risk stratification, OS in low-risk ET and low-risk PV were superimposed (P=.89) but each differed significantly from that of age- and sex-matched controls (P<.001). Leukemia-free survival was similar for ET and PV (P=.22) and significantly worse with PMF (P<.001). Compared with ET, PV was associated with higher risk of fibrotic progression (P<.001). Thrombosis risk after diagnosis was highest in PV and lowest in PMF (P=.002 for PV vs ET; P=.56 for ET vs PMF; and P=.001 for PV vs PMF). Conclusion: This study provides the most mature survival and outcomes data in MPNs and highlights MPN subgroup risk categorization as key in appraising disease natural history. The OS was only marginally better in ET compared with PV, and PV displayed a higher risk of thrombosis and fibrotic progression.
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U2 - 10.1016/j.mayocp.2018.08.022
DO - 10.1016/j.mayocp.2018.08.022
M3 - Article
C2 - 30824279
AN - SCOPUS:85061999166
SN - 0025-6196
VL - 94
SP - 599
EP - 610
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 4
ER -