How Does Race Play a Role in Complications, Survival in MPN?

Researching whether race plays a role when it comes to complications and outcomes of Philadelphia chromosome-negative myeloprofilerative neoplasms (MPN), researchers have concluded yes, and no.

While the findings of the small, single-center study indicate that there was no statistically significant difference in the rate of vascular complications between White and non-White patients with disease, there were differences in survival.

“Vascular—thrombotic and hemorrhagic—complications in Philadelphia chromosome-negative MPN have been well studied. The role of racial influence on such complications has not been systematically addressed,” said the researchers, noting that regardless of their race, all patients in the study had equal access to care.

Across the 300 patients, there were a total of 104 vascular events throughout the study period, 73 of which were thrombotic and 31 were hemorrhagic. While it did not reach statistical significance, there was a shorter time from diagnosis to the first hemorrhagic event in non-White patients.

Of note, the patients did not have a history of previous thrombotic or hemorrhagic events.

The incidence of thrombotic events did not differ between race, but the researchers did find that the risk of an event was inversely correlated with age at diagnosis. In other words, younger patients had a higher rate of thrombotic events over time.

“A possible explanation is that younger patients naturally have longer exposure to the detrimental effects of MPN or perhaps demonstrate a more aggressive disease over time,” posed the researchers. “This finding is contradictory to some previous studies stating younger patients with MPN are thought to have a lower risk of thrombosis. In fact, additional studies have shown that MPN diagnosis at a younger age leads to a higher chance of cardiovascular and cerebrovascular disease and subsequent mortality.”

Difference between race became apparent when the researchers looked at survival trends. White patients had more than double the survival time of non-White patients, who lived a median of 13 years compared to the 29 years of their White counterparts. The non-White group of 30 patients consisted of 26 African American patients, 2 Middle Eastern patients, 1 Asian patient, and 1 South Asian patient.

Meanwhile, the progression from essential thrombocytopenia and polycythemia vera to myelofibrosis, myelodysplastic syndrome, and acute myeloid leukemia was not statistically significant.

Reference

Peseski A, Saliba A, Althouse S, Sayar H. Does race play a role in complications and outcomes of Philadelphia chromosome-negative myeloproliferative neoplasms? Hematol Oncol Stem Cell Ther. Published online February 11, 2021. doi: 10.1016/j.hemonc.2021.01.005.