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Ruxolitinib-treated polycythemia vera patients and their risk of secondary malignancies

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Title: Ruxolitinib-treated polycythemia vera patients and their risk of secondary malignancies
Authors: Sekhri, Rohit, Sadjadian, Parvis, Becker, Tatjana, Kolatzki, Vera, Huenerbein, Karlo, Meixner, Raphael, Marchi, Hannah, Wallmann, Rudolf, Fuchs, Christiane, Griesshammer, Martin, Wille, Kai
Source: Ann Hematol
Ann. Hematol., DOI: 10.1007/s00277-021-04647-0 (2021)
Publisher Information: Springer Science and Business Media LLC, 2021.
Publication Year: 2021
Subject Terms: Adult, Male, 0301 basic medicine, Lymphoma, Mutation, Missense, 03 medical and health sciences, Nitriles, Humans, Hydroxyurea, Polycythemia Vera, Aged, Proportional Hazards Models, Aged, 80 and over, ddc:610, 0303 health sciences, Incidence, Neoplasms, Second Primary, Janus Kinase 2, Middle Aged, Cytoreductive Therapy, Non-melanoma Skin Carcinomas, Ruxolitinib, Secondary Malignancy, 3. Good health, Pyrimidines, Primary Myelofibrosis, Pyrazoles, Original Article, Female, Hydroxyurea/therapeutic use [MeSH], Aged, 80 and over [MeSH], Pyrazoles/adverse effects [MeSH], Aged [MeSH], Pyrazoles/therapeutic use [MeSH], Neoplasms, Second Primary/chemically induced [MeSH], Risk [MeSH], Mutation, Missense [MeSH], Neoplasms, Second Primary/epidemiology [MeSH], Proportional Hazards Models [MeSH], Male [MeSH], Primary Myelofibrosis/etiology [MeSH], Hydroxyurea/adverse effects [MeSH], Cytoreductive therapy, Pyrimidines [MeSH], Skin Neoplasms/chemically induced [MeSH], Lymphoma/chemically induced [MeSH], Female [MeSH], Follow-Up Studies [MeSH], Janus Kinase 2/genetics [MeSH], Primary Myelofibrosis/chemically induced [MeSH], Adult [MeSH], Humans [MeSH], Polycythemia Vera/drug therapy [MeSH], Polycythemia Vera/genetics [MeSH], Incidence [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Skin Neoplasms/epidemiology [MeSH], Nitriles [MeSH], Polycythemia vera, Non-melanoma skin carcinomas, Secondary malignancy, Lymphoma/epidemiology [MeSH], Follow-Up Studies
Description: Recently, there has been increased concern about a risk of secondary malignancies (SM) occurring in myelofibrosis (MF) patients receiving ruxolitinib (RUX). In polycythemia vera (PV), on the other hand, only limited data on the risk of SM under RUX treatment are available. To investigate the association between RUX therapy in PV and SM, we conducted a retrospective, single-center study that included 289 PV patients. RUX was administered to 32.9% (95/289) of patients for a median treatment duration of 48.0 months (range 1.0–101.6). Within a median follow-up of 97 months (1.0–395.0) after PV diagnosis, 24 SM occurred. Comparing the number of PV patients with RUX-associated SM (n = 10, 41.7%) with the 14 (58.3%) patients who developed SM without RUX, no significant difference (p = 0.34, chi square test) was found. No increased incidences of melanoma, lymphoma, or solid “non-skin” malignancies were observed with RUX (p = 0.31, p = 0.60, and p = 0.63, respectively, chi square test). However, significantly more NMSC occurred in association with RUX treatment (p = 0.03, chi-squared test). The “SM-free survival” was not significantly different by log rank test for all 289 patients (p = 0.65), for the patients (n = 208; 72%) receiving cytoreductive therapy (p = 0.48) or for different therapy sequences (p = 0.074). In multivariate analysis, advanced age at PV diagnosis (HR 1.062 [95% CI 1.028, 1.098]) but not administration of RUX (HR 1.068 [95% CI 0.468, 2.463]) was associated with an increased risk for SM (p = 0.005). According to this retrospective analysis, no increased risk of SM due to RUX treatment could be substantiated for PV.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1432-0584
0939-5555
DOI: 10.1007/s00277-021-04647-0
Access URL: https://link.springer.com/content/pdf/10.1007/s00277-021-04647-0.pdf
https://pubmed.ncbi.nlm.nih.gov/34462786
https://pubmed.ncbi.nlm.nih.gov/34462786/
https://link.springer.com/article/10.1007%2Fs00277-021-04647-0
https://paperity.org/p/271038365/ruxolitinib-treated-polycythemia-vera-patients-and-their-risk-of-secondary-malignancies
https://link.springer.com/content/pdf/10.1007/s00277-021-04647-0.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8510903
https://pub.uni-bielefeld.de/record/2957095
https://doi.org/10.1007/s00277-021-04647-0
https://push-zb.helmholtz-muenchen.de/frontdoor.php?source_opus=62859
https://hss-opus.ub.ruhr-uni-bochum.de/opus4/frontdoor/index/index/docId/10072
https://hss-opus.ub.ruhr-uni-bochum.de/opus4/files/10072/WilleKai31082021.pdf
https://nbn-resolving.org/urn:nbn:de:hbz:294-100723
https://repository.publisso.de/resource/frl:6447793
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) .
Accession Number: edsair.doi.dedup.....78e9b891f2bf7f1e4a71891e4bf68512
Database: OpenAIRE
Description
Abstract:Recently, there has been increased concern about a risk of secondary malignancies (SM) occurring in myelofibrosis (MF) patients receiving ruxolitinib (RUX). In polycythemia vera (PV), on the other hand, only limited data on the risk of SM under RUX treatment are available. To investigate the association between RUX therapy in PV and SM, we conducted a retrospective, single-center study that included 289 PV patients. RUX was administered to 32.9% (95/289) of patients for a median treatment duration of 48.0 months (range 1.0–101.6). Within a median follow-up of 97 months (1.0–395.0) after PV diagnosis, 24 SM occurred. Comparing the number of PV patients with RUX-associated SM (n = 10, 41.7%) with the 14 (58.3%) patients who developed SM without RUX, no significant difference (p = 0.34, chi square test) was found. No increased incidences of melanoma, lymphoma, or solid “non-skin” malignancies were observed with RUX (p = 0.31, p = 0.60, and p = 0.63, respectively, chi square test). However, significantly more NMSC occurred in association with RUX treatment (p = 0.03, chi-squared test). The “SM-free survival” was not significantly different by log rank test for all 289 patients (p = 0.65), for the patients (n = 208; 72%) receiving cytoreductive therapy (p = 0.48) or for different therapy sequences (p = 0.074). In multivariate analysis, advanced age at PV diagnosis (HR 1.062 [95% CI 1.028, 1.098]) but not administration of RUX (HR 1.068 [95% CI 0.468, 2.463]) was associated with an increased risk for SM (p = 0.005). According to this retrospective analysis, no increased risk of SM due to RUX treatment could be substantiated for PV.
ISSN:14320584
09395555
DOI:10.1007/s00277-021-04647-0