Inflammatory Comorbidities as Prognostic Factors Among Younger Patients With Myelofibrosis

Findings from a Retrospective Analysis 

Findings from a retrospective analysis published in Annals of Hematology indicated that inflammatory comorbidities demonstrate prognostic insights regarding disease development among younger patients with myelofibrosis (MF). 

According to Nathan P Horvat, MD, University of South Florida Health Morsani College of Medicine, Tampa, FL, and coauthors, “Myelofibrosis is commonly diagnosed in older individuals and has not been extensively studied in young patients.” The study authors aimed to expand research on young patients with MF and analyze possible factors that predict disease development and progression. 

A total of 63 patients with MF aged 18 to 50 years at diagnosis were included in this analysis and compared to 663 patients diagnosed at ≥ 51 years. Findings indicated that these patients were more likely to have certain characteristics, including being female, having driving calreticulin (CALR) mutation, lacking splicing gene mutations, and having low-risk disease at presentation identified by dynamic international prognostic scoring system (DIPSS). 

Among the 63 patients, 60% (n = 36) presented with incidental lab findings, and 32% (n = 19) with symptomatic disease. The median time to the first treatment was 9.4 months. A total of 14 patients underwent allogeneic hematopoietic stem cell transplantation. Blast-phase disease was observed in 5 patients at a median of 99 months post-diagnosis. 

The median overall survival among older patients with MF was 62.8 months and was unable to be reached among younger patients. Compared to older patients lacking splicing mutations, the survival advantage among younger patients was less significant. 

Before diagnosis, 49% (n = 31) of patients had comorbidities, which were correlated with increased disease risk measured by the serial DIPSS. Additionally, there was a correlation between increased risk of disease and decreased overall survival. 

“MF is rare in young adults, has distinct clinical/molecular correlates, and a favorable prognosis,” the study authors noted. 

They concluded, “The high frequency of inflammatory comorbidities and their correlation with progression of disease risk clinically highlights the role of inflammation in MF pathogenesis.” 

Source: 

Horvat NP, Abdallah EF, Xie Z, et al. Young patients with myelofibrosis have distinct clinicomolecular features, favorable prognosis, and commonly exhibit inflammatory comorbidities. Ann Hematol. Published online: November 30, 2023. doi: 10.1007/s00277-023-05564-0