1. High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib
- Author
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Rosa Daffini, Gonzalo Carreño-Tarragona, Paola Guglielmelli, Arianna Masciulli, Maria Laura Fox, Claire N. Harrison, Daniele Cattaneo, Beatriz Bellosillo, Petros Papadopoulos, Beatriz Cuevas, Maria Angeles Foncillas, Anna Angona, Alberto Ferrari, Valentín García-Gutiérrez, Arianna Ghirardi, Andrea Patriarca, Elena Maria Elli, Juan Carlos Hernández-Boluda, Tiziano Barbui, Silvia Betti, Valerio De Stefano, Giuseppe Rossi, Marta Bellini, Carmen Montoya Morcillo, Marta Sobas, Miguel Sagues Serrano, Fabrizio Cavalca, Lina Benajiba, Francesca Palandri, Emma Lopez Abadia, Marta Garrote, Alberto Alvarez-Larrán, Natalia Curto-Garcia, Mercedes Gasior Kabat, Alessandra Carobbio, Marcio Andrade-Campos, Francesca Lunghi, Marco Ruggeri, Jean-Jaques Kiladjian, Begona Navas Elorza, Elena Magro Mazo, Elisa Rumi, Giulia Benevolo, Alessandro Rambaldi, Alessandra Iurlo, Blanca Xicoy Cirici, Alessandro M. Vannucchi, Keina Susana Quiroz Cervantes, Massimiliano Bonifacio, Steffen Koschmieder, and Santiago Osorio
- Subjects
0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Ruxolitinib ,Population ,Article ,Myeloproliferative disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Risk of mortality ,Medicine ,education ,Myelofibrosis ,Survival rate ,education.field_of_study ,Univariate analysis ,business.industry ,Essential thrombocythemia ,Mortality rate ,Hematology ,medicine.disease ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Infectious diseases ,business ,medicine.drug - Abstract
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.
- Published
- 2021