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High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib.
- Source :
-
Leukemia [Leukemia] 2021 Feb; Vol. 35 (2), pp. 485-493. Date of Electronic Publication: 2021 Jan 07. - Publication Year :
- 2021
-
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 (pā=ā0.006). 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.
- Subjects :
- Aged
COVID-19 complications
COVID-19 transmission
COVID-19 virology
Europe epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myeloproliferative Disorders drug therapy
Myeloproliferative Disorders epidemiology
Myeloproliferative Disorders virology
Nitriles
Prognosis
Pyrimidines
Retrospective Studies
Survival Rate
COVID-19 mortality
Myeloproliferative Disorders mortality
Pyrazoles administration & dosage
SARS-CoV-2 isolation & purification
Withholding Treatment statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5551
- Volume :
- 35
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Leukemia
- Publication Type :
- Academic Journal
- Accession number :
- 33414483
- Full Text :
- https://doi.org/10.1038/s41375-020-01107-y