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. 2022 May 9;14(9):2331.
doi: 10.3390/cancers14092331.

Impact of Individual Comorbidities on Survival of Patients with Myelofibrosis

María García-Fortes  1   2 , Juan C Hernández-Boluda  3 , Alberto Álvarez-Larrán  4 , José M Raya  5 , Anna Angona  6 , Natalia Estrada  7 , Laura Fox  8 , Beatriz Cuevas  9 , María C García-Hernández  10 , María Teresa Gómez-Casares  11 , Francisca Ferrer-Marín  12 , Silvana Saavedra  13 , Francisco Cervantes  4 , Regina García-Delgado  1 , On Behalf Of The Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas Gemfin
Affiliations

Impact of Individual Comorbidities on Survival of Patients with Myelofibrosis

María García-Fortes et al. Cancers (Basel). .

Abstract

The comorbidity burden is an important risk factor for overall survival (OS) in several hematological malignancies. This observational prospective study was conducted to evaluate the impact of individual comorbidities on survival in a multicenter series of 668 patients with primary myelofibrosis (PMF) or MF secondary to polycythemia vera (PPV-MF) or essential thrombocythemia (PET-MF). Hypertension (hazard ratio (HR) = 4.96, p < 0.001), smoking (HR = 5.08, p < 0.001), dyslipidemia (HR = 4.65, p < 0.001) and hepatitis C virus (HCV) (HR = 4.26, p = 0.015) were most adversely associated with OS. Diabetes (HR = 3.01, p < 0.001), pulmonary disease (HR = 3.13, p < 0.001) and renal dysfunction (HR = 1.82, p = 0.037) were also associated with an increased risk of death. Multivariate analysis showed that pulmonary disease (HR = 2.69, p = 0.001), smoking (HR = 3.34, p < 0.001), renal dysfunction (HR = 2.08, p = 0.043) and HCV (HR = 11.49, p = 0.001) had a negative impact on OS. When ruxolitinib exposure was included in the model, the effect of each comorbidity on survival was modified. Therefore, individual comorbidities should be taken into account in determining the survival prognosis for patients with MF.

Keywords: comorbidities; myelofibrosis; prognosis; survival.

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Conflict of interest statement

M.G.-F. provided consultancy services to Pfizer, Novartis, Jazz Pharmaceuticals and Astellas. R.G.-D. provided consultancy services to Abbie, Novartis, Bristol-Myers Squibb, and Janssen, and received research funding from Bristol-Myers Squibb. F.F.-M. received a grant from Incyte Corporation (FFIS-CNT-2020-8) and from CTI Biophama Corp (CFE/BI/72-19; FFIS-CNT-2019-4). The remaining authors declare no competing financial interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Kaplan-Meier analyses showing overall survival in patients with MF. (A) Univariate analysis for overall survival by hypertension. (B) Univariate analysis for overall survival by diabetes. (C) Univariate analysis for overall survival by dyslipidemia. (D) Univariate analysis for overall survival by pulmonary disease. (E) Univariate analysis for overall survival by smoking. (F) Univariate analysis for overall survival by renal dysfunction.
See this image and copyright information in PMC

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