MPN-316: Impact of Comorbidities in Philadelphia Chromosome-Negative Myeloproliferative Neoplasms

Abstract

Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) are hematological disorders that occur due to clonal proliferation. Thrombosis and bleeding are more common in MPN patients in comparison to normal population. Comorbidity is a well-known negative prognostic factor for survival of patients with cancer. The aim of this study is to show the impact of comorbidities using the Charlson Comorbidity Index (CCI) on thrombotic events and bleeding episodes, as well as survival outcome in Philadelphia-negative MPNs. A retrospective cross-sectional study was carried out at Upper Egypt in Qena University hospital and Assiut University hospital between January 2014 and December 2018, in which clinical, molecular, and laboratory data of MPN patients were included. This cohort included: 62 primary myelofibrosis (PMF; 32.7%), 89 polycythemia vera (PV; 46.8%) and 39 essential thrombocytosis (ET; 20.5%) patients. Diagnosis was based on the WHO classification 2008. We computed the CCI on 190 MPN patients at diagnosis; CCI is a list of 19 comorbid conditions: each condition has a weight assigned from 1 to 6 to study the effect of comorbidity on risks of vascular events in patients with MPN, as well as survival. The endpoints were a venous or arterial thrombotic event and bleeding episodes. One-quarter of patients (n=50; 26.3%) had CCI zero (low comorbidity), 83 (43.7%) had a CCI 1–2 (moderate), and 57 (30%) had a CCI > 2 (severe). The most common comorbidities were hypertension (32.1%), coronary artery disease (12.1%), diabetes (12%), and others as reported accordingly. Forty-two patients (22.1%) had a thrombotic episode (29/42) at the time of diagnosis. CCI was significantly higher in patients with a thrombotic event vs. patients without a thrombotic event (P ≤ 0.001). CCI was higher (although not significantly) in patients with bleeding episodes of any grade vs. patients without a bleeding event (P=0.42). Overall survival (P ≤ 0.001) and progression-free survival (P