TY - JOUR
T1 - High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib
AU - Barbui, Tiziano
AU - Vannucchi, Alessandro Maria
AU - Alvarez-Larran, Alberto
AU - Iurlo, Alessandra
AU - Masciulli, Arianna
AU - Carobbio, Alessandra
AU - Ghirardi, Arianna
AU - Ferrari, Alberto
AU - Rossi, Giuseppe
AU - Elli, Elena
AU - Andrade-Campos, Marcio Miguel
AU - Kabat, Mercedes Gasior
AU - Kiladjian, Jean-Jaques
AU - Palandri, Francesca
AU - Benevolo, Giulia
AU - Garcia-Gutierrez, Valentin
AU - Fox, Maria Laura
AU - Foncillas, Maria Angeles
AU - Morcillo, Carmen Montoya
AU - Rumi, Elisa
AU - Osorio, Santiago
AU - Papadopoulos, Petros
AU - Bonifacio, Massimiliano
AU - Cervantes, Keina Susana Quiroz
AU - Serrano, Miguel Sagues
AU - Carreno-Tarragona, Gonzalo
AU - Sobas, Marta Anna
AU - Lunghi, Francesca
AU - Patriarca, Andrea
AU - Elorza, Begona Navas
AU - Angona, Anna
AU - Mazo, Elena Magro
AU - Koschmieder, Steffen
AU - Ruggeri, Marco
AU - Cuevas, Beatriz
AU - Hernandez-Boluda, Juan Carlos
AU - Abadia, Emma Lopez
AU - Cirici, Blanca Xicoy
AU - Guglielmelli, Paola
AU - Garrote, Marta
AU - Cattaneo, Daniele
AU - Daffini, Rosa
AU - Cavalca, Fabrizio
AU - Bellosillo, Beatriz
AU - Benajiba, Lina
AU - Curto-Garcia, Natalia
AU - Bellini, Marta
AU - Betti, Silvia
AU - De Stefano, Valerio
AU - Harrison, Claire
AU - Rambaldi, Alessandro
PY - 2021
Y1 - 2021
N2 - We report the clinical presentation and risk factors for survival in 175 patients with myeloproliferative neoplasms (MPN) and COVID-19, diagnosed between February and June 2020. After a median follow-up of 50 days, mortality was higher than in the general population and reached 48% in myelofibrosis (MF). Univariate analysis, showed a significant relationship between death and age, male gender, decreased lymphocyte counts, need for respiratory support, comorbidities and diagnosis of MF, while no association with essential thrombocythemia (ET), polycythemia vera (PV), and prefibrotic-PMF (pre-PMF) was found. Regarding MPN-directed therapy ongoing at the time of COVID-19 diagnosis, Ruxolitinib (Ruxo) was significantly more frequent in patients who died in comparison with survivors (p = 0.006). Conversely, multivariable analysis found no effect of Ruxo alone on mortality, but highlighted an increased risk of death in the 11 out of 45 patients who discontinued treatment. These findings were also confirmed in a propensity score matching analysis. In conclusion, we found a high risk of mortality during COVID-19 infection among MPN patients, especially in MF patients and/or discontinuing Ruxo at COVID-19 diagnosis. These findings call for deeper investigation on the role of Ruxo treatment and its interruption, in affecting mortality in MPN patients with COVID-19.
AB - We report the clinical presentation and risk factors for survival in 175 patients with myeloproliferative neoplasms (MPN) and COVID-19, diagnosed between February and June 2020. After a median follow-up of 50 days, mortality was higher than in the general population and reached 48% in myelofibrosis (MF). Univariate analysis, showed a significant relationship between death and age, male gender, decreased lymphocyte counts, need for respiratory support, comorbidities and diagnosis of MF, while no association with essential thrombocythemia (ET), polycythemia vera (PV), and prefibrotic-PMF (pre-PMF) was found. Regarding MPN-directed therapy ongoing at the time of COVID-19 diagnosis, Ruxolitinib (Ruxo) was significantly more frequent in patients who died in comparison with survivors (p = 0.006). Conversely, multivariable analysis found no effect of Ruxo alone on mortality, but highlighted an increased risk of death in the 11 out of 45 patients who discontinued treatment. These findings were also confirmed in a propensity score matching analysis. In conclusion, we found a high risk of mortality during COVID-19 infection among MPN patients, especially in MF patients and/or discontinuing Ruxo at COVID-19 diagnosis. These findings call for deeper investigation on the role of Ruxo treatment and its interruption, in affecting mortality in MPN patients with COVID-19.
KW - Covid-19
KW - Covid-19
UR - http://hdl.handle.net/10807/303483
U2 - 10.1038/s41375-020-01107-y
DO - 10.1038/s41375-020-01107-y
M3 - Article
SN - 1476-5551
VL - 35
SP - 485
EP - 493
JO - Leukemia
JF - Leukemia
ER -