|The following article features coverage from the 2021 American Society of Hematology Annual Meeting. Click here to read more of Cancer Therapy Advisor’s conference coverage.|
Excess mortality from myeloproliferative neoplasms (MPNs) is significantly greater in young patients (aged less than 60 years) compared with older patients (aged 60 years and older) in the United States, according to a study presented at the 2021 American Society of Hematology (ASH) Annual Meeting.
“[Y]oung MPN patients have high excess mortality not eliminated by conservative treatment,” said study presenter Khalid Abu-Zeinah, of the University of Cambridge in the United Kingdom. “Our goal was to highlight the unmet need for younger patients by identifying and implementing life-prolonging treatment.”
The researchers used Surveillance, Epidemiology, and End Results (SEER) data to identify 40,333 patients who were diagnosed with MPNs at a median age of 66 years and examined the demographics, survival, and cause of death of these individuals in relation to comparable noncancer controls. Excess mortality was calculated by the ratio of observed mortality in patients with MPNs divided by the expected mortality of the US population, matched by age, sex, race, and birth year.
The 10-year mortality for young patients with essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF) was 13%, 18%, and 49%, respectively (vs 6% for controls); and was 59%, 59%, and 87%, respectively (vs 35% for controls) in older patients.
Excess all-cause mortality was greater in younger patients compared to older patients with ET (2.75 vs 1.82; P <.001), PV (3.16 vs 1.92, P <.001), and PMF (10.6 vs 5.73; P <.001).
Excess cardiovascular mortality was also higher in younger patients compared with older patients with PV (3.36 vs 2.55, P =.036), but not in ET or PMF. Excess cancer-related mortality was also higher for young patients with PV vs 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 PMF, but not significantly different in young patients vs older patients.
Abu-Zeinah and colleagues hypothesized that differences in excess mortality could be linked to age-biased risk assessment and guidelines that recommend lower intensity treatment for young patients.
He further explained that these data suggest early intervention with potentially disease-modifying treatment may beneficial for all patients, irrespective of age.
“Further clinical trials evaluating early intervention with potentially life-prolonging treatments are needed,” he concluded.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Read more of Cancer Therapy Advisor’s coverage of the ASH 2021 meeting by visiting the conference page.
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. Abstract 235.