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

Szczegóły
Abstrakt

Tytuł:: Impact of comorbidities and body mass index on the outcome of polycythemia vera patients.
Autorzy:: Benevolo G; Division of Hematology, Città della Salute e della Scienza Hospital, Torino, Italy.
Elli EM; Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy.
Bartoletti D; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', Bologna, Italy.; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna Bologna, Italy.
Latagliata R; Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy.
Tiribelli M; Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
Heidel FH; Department of Hematology and Oncology, Friedrich-Schiller-University Medical Center, Jena, Germany.
Cavazzini F; Division of Hematology, University of Ferrara, Ferrara, Italy.
Bonifacio M; Department of Hematology, University of Verona, Verona, Italy.
Crugnola M; Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Binotto G; Unit of Hematology and Clinical Immunology, University of Padova, Padova, Italy.
D'Addio A; Division of Hematology, Onco-Hematologic Department, AUSL della Romagna, Ravenna, Italy.
Tieghi A; Department of Hematology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Bergamaschi M; Department of Internal Medicine (DiMI), Clinic of Hematology, University of Genoa, Genova, Italy.
Caocci G; Hematology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
Polverelli N; Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili di Brescia, Brescia, Italy.
Bossi E; Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy.
Auteri G; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', Bologna, Italy.; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna Bologna, Italy.
Carmosino I; Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy.
Catani L; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', Bologna, Italy.
Cuneo A; Division of Hematology, University of Ferrara, Ferrara, Italy.
Krampera M; Department of Hematology, University of Verona, Verona, Italy.
Lanza F; Division of Hematology, Onco-Hematologic Department, AUSL della Romagna, Ravenna, Italy.
Lemoli RM; Department of Internal Medicine (DiMI), Clinic of Hematology, University of Genoa, Genova, Italy.; IRCCS Policlinico San Martino, Genova, Italy.
Vianelli N; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', Bologna, Italy.
Breccia M; Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy.
Palumbo GA; Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate 'G.F. Ingrassia', University of Catania, Catania, Italy.
Cavo M; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', Bologna, Italy.
Palandri F; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia 'Seràgnoli', Bologna, Italy.
Źródło:: Hematological oncology [Hematol Oncol] 2021 Aug; Vol. 39 (3), pp. 409-418. Date of Electronic Publication: 2021 Mar 08.
Typ publikacji:: Journal Article; Multicenter Study; Observational Study
Język:: English
Imprint Name(s):: Original Publication: Oxford, England : Wiley-Blackwell, c1983-
MeSH Terms:: Body Mass Index*
Polycythemia Vera/*mortality
Primary Myelofibrosis/*mortality
Thrombosis/*mortality
Adult ; Aged ; Aged, 80 and over ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Polycythemia Vera/therapy ; Primary Myelofibrosis/therapy ; Retrospective Studies ; Risk Factors ; Thrombosis/therapy
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Grant Information:: AIL Bologna
Contributed Indexing:: Keywords: Charlson comorbidity index; body mass index; cancer; outcome; polycythemia vera; thrombotic risk
Entry Date(s):: Date Created: 20210216 Date Completed: 20210817 Latest Revision: 20210817
Update Code:: 20240104
DOI:: 10.1002/hon.2843
PMID:: 33590502
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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.
(© 2021 John Wiley & Sons Ltd.)

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