Blast phase myeloproliferative neoplasm: Mayo-AGIMM study of 410 patients from two separate cohorts

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Ayalew,Mudireddy,Mythri,Mannelli,Francesco,Begna,K H.,Patnaik,Mrinal M.,Hanson,Curtis A.,Ketterling,R Tefferi (Creator)

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East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: A total of 410 patients with blast phase myeloproliferative neoplasm (MPN-BP) were retrospectively reviewed: 248 from theMayo Clinic and 162 from Italy. Median survival was 3.6 months, with no improvement over the last 15 years. Multivariableanalysis performed on the Mayo cohort identified high risk karyotype, platelet count < 100 × 109/L, age > 65 years andtransfusion need as independent risk factors for survival. Also in the Mayo cohort, intensive chemotherapy resulted in completeremission (CR) or CR with incomplete count recovery (CRi) rates of 35 and 24%, respectively; treatment-specified 3-year/5-yearsurvival rates were 32/10% for patients receiving allogeneic stem cell transplant (AlloSCT) (n = 24), 19/13% for patientsachieving CR/CRi but were not transplanted (n = 24), and 1/1% in the absence of both AlloSCT and CR/CRi (n = 200) (p <0.01). The survival impact of AlloSCT (HR 0.2, 95% CI 0.1--0.3), CR/CRi without AlloSCT (HR 0.3, 95% CI 0.2--0.5), high riskkaryotype (HR 1.6, 95% CI 1.1--2.2) and platelet count < 100 × 109/L (HR 1.6, 95% CI 1.1--2.2) were confirmed to be interindependent. Similar observations were made in the Italian cohort. The current study identifies the setting for improved short-termsurvival in MPN-BP, but also highlights the limited value of current therapy, including AlloSCT, in securing long-term survival.

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Other

Language: English

Date: 2018

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