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Article: Myeloproliferative neoplasms treated with hydroxyurea, pegylated interferon alpha-2A or ruxolitinib: clinicohematologic responses, quality-of-life changes and safety in the real-world setting

TitleMyeloproliferative neoplasms treated with hydroxyurea, pegylated interferon alpha-2A or ruxolitinib: clinicohematologic responses, quality-of-life changes and safety in the real-world setting
Authors
KeywordsMyeloproliferative neoplasms
polycythemia vera
essential thrombocythemia
primary myelofibrosis
hydroxyurea
Issue Date2020
PublisherTaylor & Francis. The Journal's web site is located at http://www.tandfonline.com/loi/yhem20
Citation
Hematology, 2020, v. 25 n. 1, p. 247-257 How to Cite?
AbstractIntroduction: Real-world data of responses, quality-of-life (QOL) changes and adverse events in patients with myeloproliferative neoplasms (MPN) on conventional therapy (hydroxyurea ± anagrelide), pegylated interferon alpha-2A (PEG-IFNα-2A) or ruxolitinib are limited. Methods: We prospectively studied MPN patients receiving conventional therapy, PEG-IFNα-2A or ruxolitinib. Next-generation sequencing of 69 myeloid-related genes was performed. Clinicohematologic responses, adverse events, and QOL (determined by the Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score, MPN-SAF TSS) were evaluated. Results: Seventy men and fifty-five women with polycythemia vera (PV) (N = 23), essential thrombocythemia (ET) (N = 56) and myelofibrosis (MF) (N = 46) were studied for a median of 36 (range: 19–42) months. In PV, responses were comparable for different modalities. CREBBP mutations were associated with inferior responses. In ET, PEG-IFNα-2A resulted in superior clinicohematologic complete responses (CHCR) (P = 0.045). In MF, superior overall response rates (ORR) were associated with ruxolintib (P = 0.018) and JAK2V617F mutation (P = 0.04). For the whole cohort, ruxolitinib led to rapid and sustained reduction in spleen size within the first 6 months, and significant improvement of QOL as reflected by reduction in MPN-SAF TSS (P < 0.001). Adverse events of grades 1–2 were observed in 44%, 62% and 20% of patients receiving conventional therapy, PEG-IFNα-2A and ruxolitinib respectively; and of grade 3–4 in 7% and 9% of patients receiving PEG-IFNα-2A and ruxolitinib. Conclusions: Conventional therapy, PEG-IFNα-2A and ruxolitinib induced responses in all MPN subtypes. PEG-IFNα-2A led to superior CHCR in ET; whereas ruxolitinib resulted in superior ORR in MF, and significant reduction in spleen size and improvement in QOL.
Persistent Identifierhttp://hdl.handle.net/10722/283674
ISSN
2020 Impact Factor: 2.269
2015 SCImago Journal Rankings: 0.420
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorGill, H-
dc.contributor.authorLeung, GMK-
dc.contributor.authorYim, R-
dc.contributor.authorLee, P-
dc.contributor.authorPang, HH-
dc.contributor.authorIp, HW-
dc.contributor.authorLeung, RYY-
dc.contributor.authorLi, J-
dc.contributor.authorPanagiotou, G-
dc.contributor.authorMa, ESK-
dc.contributor.authorKwong, YL-
dc.date.accessioned2020-07-03T08:22:32Z-
dc.date.available2020-07-03T08:22:32Z-
dc.date.issued2020-
dc.identifier.citationHematology, 2020, v. 25 n. 1, p. 247-257-
dc.identifier.issn1024-5332-
dc.identifier.urihttp://hdl.handle.net/10722/283674-
dc.description.abstractIntroduction: Real-world data of responses, quality-of-life (QOL) changes and adverse events in patients with myeloproliferative neoplasms (MPN) on conventional therapy (hydroxyurea ± anagrelide), pegylated interferon alpha-2A (PEG-IFNα-2A) or ruxolitinib are limited. Methods: We prospectively studied MPN patients receiving conventional therapy, PEG-IFNα-2A or ruxolitinib. Next-generation sequencing of 69 myeloid-related genes was performed. Clinicohematologic responses, adverse events, and QOL (determined by the Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score, MPN-SAF TSS) were evaluated. Results: Seventy men and fifty-five women with polycythemia vera (PV) (N = 23), essential thrombocythemia (ET) (N = 56) and myelofibrosis (MF) (N = 46) were studied for a median of 36 (range: 19–42) months. In PV, responses were comparable for different modalities. CREBBP mutations were associated with inferior responses. In ET, PEG-IFNα-2A resulted in superior clinicohematologic complete responses (CHCR) (P = 0.045). In MF, superior overall response rates (ORR) were associated with ruxolintib (P = 0.018) and JAK2V617F mutation (P = 0.04). For the whole cohort, ruxolitinib led to rapid and sustained reduction in spleen size within the first 6 months, and significant improvement of QOL as reflected by reduction in MPN-SAF TSS (P < 0.001). Adverse events of grades 1–2 were observed in 44%, 62% and 20% of patients receiving conventional therapy, PEG-IFNα-2A and ruxolitinib respectively; and of grade 3–4 in 7% and 9% of patients receiving PEG-IFNα-2A and ruxolitinib. Conclusions: Conventional therapy, PEG-IFNα-2A and ruxolitinib induced responses in all MPN subtypes. PEG-IFNα-2A led to superior CHCR in ET; whereas ruxolitinib resulted in superior ORR in MF, and significant reduction in spleen size and improvement in QOL.-
dc.languageeng-
dc.publisherTaylor & Francis. The Journal's web site is located at http://www.tandfonline.com/loi/yhem20-
dc.relation.ispartofHematology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectMyeloproliferative neoplasms-
dc.subjectpolycythemia vera-
dc.subjectessential thrombocythemia-
dc.subjectprimary myelofibrosis-
dc.subjecthydroxyurea-
dc.titleMyeloproliferative neoplasms treated with hydroxyurea, pegylated interferon alpha-2A or ruxolitinib: clinicohematologic responses, quality-of-life changes and safety in the real-world setting-
dc.typeArticle-
dc.identifier.emailGill, H: gillhsh@hku.hk-
dc.identifier.emailYim, R: ritayim@hku.hk-
dc.identifier.emailLee, P: pl85@hku.hk-
dc.identifier.emailPang, HH: herbpang@hku.hk-
dc.identifier.emailIp, HW: iphowan@hku.hk-
dc.identifier.emailLeung, RYY: leungyyr@hku.hk-
dc.identifier.emailPanagiotou, G: gipa@hku.hk-
dc.identifier.emailMa, ESK: eskma@hku.hk-
dc.identifier.emailKwong, YL: ylkwong@hkucc.hku.hk-
dc.identifier.authorityGill, H=rp01914-
dc.identifier.authorityPang, HH=rp01857-
dc.identifier.authorityPanagiotou, G=rp01725-
dc.identifier.authorityKwong, YL=rp00358-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1080/16078454.2020.1780755-
dc.identifier.pmid32567517-
dc.identifier.scopuseid_2-s2.0-85086855847-
dc.identifier.hkuros310700-
dc.identifier.volume25-
dc.identifier.issue1-
dc.identifier.spage247-
dc.identifier.epage257-
dc.identifier.isiWOS:000546534500001-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1024-5332-

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