Excess mortality is higher in younger patients with PND than in older patients

The excess mortality from myeloproliferative neoplasms (MPNs) was significantly higher in young patients (aged less than 60 years) than in older patients (aged 60 years and older) in the United States, according to a study presented in the 2021 American Society of Hematology (ASH) Annual Meeting.

“Despite shortened survival, young patients with MPN have a high excess mortality which is not eliminated by conservative treatment,” said study presenter Khalid Abu-Zeinah, from the University of Cambridge in the UK. United. “Our goal was to highlight the unmet need of younger patients by identifying and implementing life-prolonging treatment. “

Researchers used surveillance, epidemiology, and endpoint (SEER) data to identify 40,333 patients who were diagnosed with MPN at a median age of 66 years and looked at demographics, survival, and cause of the deaths of these individuals compared to comparable non-cancerous controls. . Excess mortality was calculated as the ratio of mortality observed in patients with PND divided by the expected mortality of the US population, matched by age, sex, race and year of birth.

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The 10-year mortality for young patients with essential thrombocythemia (ET), essential polycythemia (PV) and primary myelofibrosis (PMF) was 13%, 18% and 49%, respectively (compared to 6% for controls); and was 59%, 59% and 87%, respectively (vs. 35% for controls) in older patients.

All-cause excess mortality was higher in younger patients than in older patients with ET (2.75 vs. 1.82; P <.001 hp vs.>P P <.001>

The excess cardiovascular mortality was also higher in younger patients than in older patients with PV (3.36 vs 2.55, P = .036), but not in ET or PMF; excess cancer-related mortality was also higher in young patients with PV than in older patients (2.36 vs. 1.53, P = .002), but not in ET or PMF. In addition, excess acute leukemia mortality was high for all patients, especially FMP, but was not significantly different in young patients compared to older patients.

Abu-Zeinah and his colleagues hypothesized that the differences in excess mortality may be related to an age-biased risk assessment and guidelines that recommend lower intensity treatment for young patients.

He further explained that these data suggest that early intervention with potentially disease-modifying treatment may be beneficial for all patients, regardless of age.

“Further clinical trials evaluating early intervention with potentially prolonged treatments are needed,” he concluded.

Disclosure: Some study authors reported affiliations with biotech, pharmaceutical, and / or device companies. Please see the original reference for a full list of author disclosures.

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Abu-Zeinah K, Saadeh K, Silver RT, et al. Excess mortality in young patients with myeloproliferative neoplasms. Presented at ASH 2021; December 11-14, 2021. Summary 235.

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