TY - JOUR
T1 - Monocytosis in polycythemia vera
T2 - Clinical and molecular correlates
AU - Barraco, Daniela
AU - Cerquozzi, Sonia
AU - Gangat, Naseema
AU - Patnaik, Mrinal M.
AU - Lasho, Terra
AU - Finke, Christy
AU - Hanson, Curtis A.
AU - Ketterling, Rhett P.
AU - Pardanani, Animesh
AU - Tefferi, Ayalew
N1 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2017/7
Y1 - 2017/7
N2 - Monocytosis (absolute monocyte count, AMC ≥ 1 × 109/L) might accompany a spectrum of myeloid neoplasms, other than chronic myelomonocytic leukemia (CMML). In the current study, we examined the prevalence, laboratory and molecular correlates, and prognostic relevance of monocytosis in polycythemia vera (PV). Among 267 consecutive patients with World Health Organization (WHO)-defined PV, 55 (21%) patients displayed an AMC of ≥1 × 109/L and 18 (7%) an AMC of ≥1.5 × 109/L. In general, PV patients with monocytosis were significantly older and displayed higher frequencies of leukocytosis (81% vs. 50% at AMC ≥1 × 109/L) and TET2/SRSF2 mutations (57%/29% vs. 19%/1% at AMC ≥ 1.5 × 109/L). In univariate analysis, AMC ≥1.5 × 109/L adversely affected overall (OS; P =.004; HR 2.6, 95% CI 1.4-4.8) and myelofibrosis-free (MFFS; P =.02; HR 4.4, 95% CI 1.3-15.1) survival; during multivariable analysis, significance was borderline sustained for OS (P =.05) and MFFS (P =.06). Other independent risk factors for OS included unfavorable karyotype (P =.02, HR 3.39, 95% CI 1.17-9.79), older age (P <.0001, HR 3.34 95% CI 1.97-5.65), and leukocytosis ≥15 × 109/L (P =.004, HR 2.04, 95% CI 1.26-3.29). In conclusion, in the current study, we encountered a higher than expected prevalence of monocytosis in patients with PV and the mutation profile and age distribution of PV patients with monocytosis is akin to those of patients with CMML and might partly contribute to their worse prognosis.
AB - Monocytosis (absolute monocyte count, AMC ≥ 1 × 109/L) might accompany a spectrum of myeloid neoplasms, other than chronic myelomonocytic leukemia (CMML). In the current study, we examined the prevalence, laboratory and molecular correlates, and prognostic relevance of monocytosis in polycythemia vera (PV). Among 267 consecutive patients with World Health Organization (WHO)-defined PV, 55 (21%) patients displayed an AMC of ≥1 × 109/L and 18 (7%) an AMC of ≥1.5 × 109/L. In general, PV patients with monocytosis were significantly older and displayed higher frequencies of leukocytosis (81% vs. 50% at AMC ≥1 × 109/L) and TET2/SRSF2 mutations (57%/29% vs. 19%/1% at AMC ≥ 1.5 × 109/L). In univariate analysis, AMC ≥1.5 × 109/L adversely affected overall (OS; P =.004; HR 2.6, 95% CI 1.4-4.8) and myelofibrosis-free (MFFS; P =.02; HR 4.4, 95% CI 1.3-15.1) survival; during multivariable analysis, significance was borderline sustained for OS (P =.05) and MFFS (P =.06). Other independent risk factors for OS included unfavorable karyotype (P =.02, HR 3.39, 95% CI 1.17-9.79), older age (P <.0001, HR 3.34 95% CI 1.97-5.65), and leukocytosis ≥15 × 109/L (P =.004, HR 2.04, 95% CI 1.26-3.29). In conclusion, in the current study, we encountered a higher than expected prevalence of monocytosis in patients with PV and the mutation profile and age distribution of PV patients with monocytosis is akin to those of patients with CMML and might partly contribute to their worse prognosis.
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U2 - 10.1002/ajh.24740
DO - 10.1002/ajh.24740
M3 - Article
C2 - 28370365
AN - SCOPUS:85019679344
SN - 0361-8609
VL - 92
SP - 640
EP - 645
JO - American journal of hematology
JF - American journal of hematology
IS - 7
ER -