Race May Influence Clinical Outcomes in Myeloproliferative Neoplasms

Non-Caucasian patients with myeloproliferative neoplasms have an increased risk for developing vascular complications, while Caucasian patients have a higher risk of progression to myelofibrosis, a study published in the journal Clinical Lymphoma, Myeloma, & Leukemia has shown.¹

The Philadelphia chromosome-negative myeloproliferative neoplasms, such as polycythemia vera, essential thrombocytopenia, and myelofibrosis, are characterized by an increased risk for developing thrombotic and hemorrhagic complications. Although large retrospective studies have attributed racial disparities in myeloproliferative neoplasm outcomes to access to health care, researchers hypothesized that race may impact outcomes.

For the single-institution study, researchers analyzed data from 127 Caucasian and non-Caucasian adult patients with myeloproliferative neoplasms treated at the University of Illinois between 1990 and 2012.

Results showed that non-Caucasian patients with polycythemia vera had a higher risk of vascular complications, including cardiovascular thrombosis and hemorrhagic events, whereas Caucasian patients with polycythemia vera and essential thrombocytopenia were more likely to progress to myelofibrosis.

Furthermore, researchers found that Caucasian race was an independent prognostic factor protective against cardiovascular thrombosis among those with polycythemia vera and essential thrombocytopenia (HR, 0.2; 95% CI, 0.03 – 0.9; P = .04). In contrast, age greater than 60 years and prior thrombosis were significant risk factors of cardiovascular thrombosis.

The study also demonstrated that non-Caucasian race, particularly African American ethnicity, was a significant risk factor of hemorrhagic complications of polycythemia vera and essential thrombocytopenia.

“This study shows for the first time that race can influence clinical outcomes in myeloproliferative neoplasms,” the authors concluded. “This study highlights the need for greater representation of non-Caucasian patients in studies investigating vascular risk factors in myeloproliferative neoplasms.

Reference

1. Khan I, Saraf SL, Shergill A, et al. Outcome disparities in Caucasian and non-Caucasian patients with myeloproliferative neoplasms [published online ahead of print March 8, 2016]. Clin Lymphoma Myeloma Leuk. doi: 10.1016/j.clml.2016.02.036.