Impact of comorbidities and body mass index on the outcome of polycythemia vera patients

被引：20

作者：

Benevolo, Giulia ^{[1
]}

Elli, Elena M. ^{[2
]}

Bartoletti, Daniela ^{[3
,4
]}

Latagliata, Roberto ^{[5
]}

Tiribelli, Mario ^{[6
]}

Heidel, Florian H. ^{[7
]}

Cavazzini, Francesco ^{[8
]}

Bonifacio, Massimiliano ^{[9
]}

Crugnola, Monica ^{[10
]}

Binotto, Gianni ^{[11
]}

D'Addio, Alessandra ^{[12
]}

Tieghi, Alessia ^{[13
]}

Bergamaschi, Micaela ^{[14
]}

Caocci, Giovanni ^{[15
]}

Polverelli, Nicola ^{[16
]}

Bossi, Elisa ^{[2
]}

Auteri, Giuseppe ^{[3
,4
]}

Carmosino, Ida ^{[5
]}

Catani, Lucia ^{[3
]}

Cuneo, Antonio ^{[9
]}

Krampera, Mauro ^{[10
]}

Lanza, Francesco ^{[12
]}

Lemoli, Roberto M. ^{[17
]}

Vianelli, Nicola ^{[3
]}

Breccia, Massimo ^{[5
]}

Palumbo, Giuseppe A. ^{[18
]}

Cavo, Michele ^{[3
]}

Palandri, Francesca ^{[3
]}

机构：

[1] Citta Salute & Sci Hosp, Div Hematol, Turin, Italy

[2] San Gerardo Hosp, ASST Monza, Hematol Div, Monza, Italy

[3] IRCCS Azienda Osped Univ Bologna, Ist Ematol Seragnoli, Via Albertoni 15, I-40138 Bologna, Italy

[4] Univ Bologna, Dipartimento Med Specialist Diagnost & Sperimenta, Bologna, Italy

[5] Univ Sapienza, Div Cellular Biotechnol & Hematol, Rome, Italy

[6] Azienda Sanit Univ Integrata Udine, Div Hematol & BMT, Udine, Italy

[7] Friedrich Schiller Univ Med Ctr, Dept Hematol & Oncol, Jena, Germany

[8] Univ Ferrara, Div Hematol, Ferrara, Italy

[9] Univ Verona, Dept Hematol, Verona, Italy

[10] Azienda Osped Univ Parma, Div Hematol, Parma, Italy

[11] Univ Padua, Unit Hematol & Clin Immunol, Padua, Italy

[12] AUSL Romagna, Oncohematol Dept, Div Hematol, Ravenna, Italy

[13] Azienda USL IRCCS Reggio Emilia, Dept Hematol, Reggio Emilia, Italy

[14] Univ Genoa, Clin Hematol, Dept Internal Med DiMI, Genoa, Italy

[15] Univ Cagliari, Dept Med Sci, Hematol Unit, Cagliari, Italy

[16] ASST Spedali Civili Brescia, Unit Blood Dis & Stem Cell Transplantat, Brescia, Italy

[17] IRCCS Policlin San Martino, Genoa, Italy

[18] Univ Catania, Dept Sci Med Chirurg & Tecnol Avanzate GF Ingrass, Catania, Italy

来源：

HEMATOLOGICAL ONCOLOGY | 2021年 / 39卷 / 03期

关键词：

body mass index; cancer; Charlson comorbidity index; outcome; polycythemia vera; thrombotic risk; MYELOPROLIFERATIVE NEOPLASMS; RISK; RUXOLITINIB; SURVIVAL; HYDROXYCARBAMIDE; CLASSIFICATION; MYELOFIBROSIS; EFFICACY; CRITERIA; THERAPY;

D O I：

10.1002/hon.2843

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

In 816 patients with 2016 World Health Organization-defined polycythemia vera (PV) enrolled in a multicenter retrospective study, we investigated the predictive value of Charlson comorbidity index (CCI) and body mass index (BMI) on thrombosis, progression to post-PV myelofibrosis (PPV-MF) and survival. Patients were subgrouped according to CCI = 0 (58.1%, no comorbidities) or CCI >= 1 (41.9%) and according to normal/underweight (BMI < 25, 54.5%) or overweight/obesity (BMI >= 25, 45.5%) at PV diagnosis. BMI was available for 529 patients. Patients with CCI >= 1 were older and more frequently presented cardiovascular risk factors compared to patients with CCI = 0 (p < 0.001), while overweight/obese patients were more frequently males (p < 0.001). Cumulative incidence of thromboses with death as competing risk was 13.3% at 10 years. Multivariable analysis with death as competing risk showed that previous thromboses (subdistribution hazard ratio [SHR]: 2.1, p = 0.01) and hypertension (SHR: 1.77, p = 0.04) were significantly associated with a higher thrombotic risk, while BMI >= 25 lost statistical significance (SHR: 1.69, p = 0.05) and CCI >= 1 was excluded after evaluation of goodness of fit. After a median follow-up of 6.1 years, progression to PPV-MF occurred in 44 patients, and 75 patients died. BMI >= 25 was associated with a lower probability of progression to PPV-MF (SHR: 0.38, CI95%: 0.15-0.94, p = 0.04) and better survival (hazard ratio [HR]: 0.42, CI95%: 0.18-0.97, p = 0.04). CCI >= 1 did not affect progression to PPV-MF (p = 0.44) or survival (p = 0.71). The evaluation of CCI and BMI may improve the prognostic definition of PV. In patients with hypertension an accurate evaluation of thrombotic risk is warranted.

引用

页码：409 / 418

页数：10