Thrombotic events and mortality risk in patients with newly diagnosed polycythemia vera or essential thrombocythemia. (April 2022)

• Record Type: Journal Article
• Authors: Pemmaraju, Naveen; Gerds, Aaron T.; Yu, Jingbo; Parasuraman, Shreekant; Shah, Anne; Xi, Ann; Kumar, Shambhavi; Scherber, Robyn M.; Verstovsek, Srdan
• Is Part Of: Leukemia research. Volume 115(2022)
• Publication Date: 2022-04
• Subjects: Essential thrombocythemia -- Myeloproliferative neoplasms -- Polycythemia vera -- Survival -- Thrombotic events; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2022.106809
• Languages: English
• ISSNs: 0145-2126

Abstract

Abstract: Patients with polycythemia vera (PV) and essential thrombocythemia (ET) have increased thrombotic risk. This retrospective, real-world analysis of Medicare patients (age ≥ 65 years) newly diagnosed with high-risk PV or intermediate-/high-risk ET compared mortality risk among those with versus without thrombotic events during the study period. Patients diagnosed with PV or ET with ≥ 1 inpatient or ≥ 2 outpatient claims (January 1, 2010–December 31, 2017; index was date of first qualifying claim) were included. The study included 50, 405 Medicare beneficiaries with PV and 124, 569 with ET. During follow-up (median [range]: PV, 34.5 [0–97.3] months; ET, 25.5 [0–97.4] months), 14, 334 patients (28.4%) with PV and 30, 478 (24.5%) with ET experienced thrombotic events (most commonly ischemic stroke [PV, 46.0%; ET, 42.5%]. Mortality risk was increased for patients with versus without post-index thrombosis for both PV (adjusted hazard ratio [aHR; 95% CI], 18.6 [16.1–21.6]; P < 0.001) and ET (aHR [95% CI], 25.2 [23.1–27.5]; P < 0.001). Median survival was shorter for patients who experienced a thrombotic event ≤ 1 year post-index versus those who did not (PV, 5.1 years vs not reached; ET, 3.7 vs 6.7 years; both P < 0.001). These findings highlight the importance of thrombosis risk mitigation in PV and ET management. Graphical Abstract: ga1 Highlights: Patients with PV and ET have increased risk for thrombotic events (TEs). We compared mortality risk among patients with PV or ET with vs without TEs. During follow-up (PV, 35 mo; ET, 26 mo), 28% (PV) and 24% (ET) of patients had a TE. Mortality risk was higher and survival was shorter among those with vs without TEs.