Comorbidities defined by the Charlson comorbidity index (CCI) and body mass index (BMI) are significantly associated with outcome in patients who receive continuous treatment with tyrosine kinase inhibitors. We evaluated the impact of CCI and BMI on responses, drug-related toxicities, and outcome in a cohort of 402 patients with myelofibrosis (MF) treated with ruxolitinib in 23 European Hematology Centers. Comorbidities were evaluable in all 402 patients. A higher (≥ 3) CCI did not correlate with a lower spleen reduction at any time (p = 0.68) or symptoms' response (p = 0.11), but influenced the onset of anemia during the first 3 months of treatment and later (p = 0.02 and p = 0.03, respectively) in patients without anemia baseline. BMI was evaluable in 380 patients and did not correlate with differences in spleen and symptoms response (p = 0.57 and p = 0.49, respectively). A higher CCI and a lower BMI correlated also with a reduced overall survival (p < 0.001 and p = 0.02, respectively). The achievement of a spleen response at 6 months could counterbalance the negative impact of comorbidities, while patients who were underweight when starting ruxolitinib and did not achieve a spleen response at 6 months were projected to the worse outcome. In MF patients treated with ruxolitinib, BMI and comorbidities did not influence the achievement of spleen/symptom responses, but they contributed to the early identification of patients who deserve a strict monitoring during treatment.

Impact of comorbidities and body mass index in patients with myelofibrosis treated with ruxolitinib

Daniela Bartoletti;Nicola Polverelli;Alessandro Isidori;Costanza Bosi;Giuseppe Auteri;Roberto M. Lemoli;Domenico Russo;Lucia Catani;Michele Cavo;Nicola Vianelli;Francesca Palandri
2019

Abstract

Comorbidities defined by the Charlson comorbidity index (CCI) and body mass index (BMI) are significantly associated with outcome in patients who receive continuous treatment with tyrosine kinase inhibitors. We evaluated the impact of CCI and BMI on responses, drug-related toxicities, and outcome in a cohort of 402 patients with myelofibrosis (MF) treated with ruxolitinib in 23 European Hematology Centers. Comorbidities were evaluable in all 402 patients. A higher (≥ 3) CCI did not correlate with a lower spleen reduction at any time (p = 0.68) or symptoms' response (p = 0.11), but influenced the onset of anemia during the first 3 months of treatment and later (p = 0.02 and p = 0.03, respectively) in patients without anemia baseline. BMI was evaluable in 380 patients and did not correlate with differences in spleen and symptoms response (p = 0.57 and p = 0.49, respectively). A higher CCI and a lower BMI correlated also with a reduced overall survival (p < 0.001 and p = 0.02, respectively). The achievement of a spleen response at 6 months could counterbalance the negative impact of comorbidities, while patients who were underweight when starting ruxolitinib and did not achieve a spleen response at 6 months were projected to the worse outcome. In MF patients treated with ruxolitinib, BMI and comorbidities did not influence the achievement of spleen/symptom responses, but they contributed to the early identification of patients who deserve a strict monitoring during treatment.
Massimo Breccia; Daniela Bartoletti; Massimiliano Bonifacio; Giuseppe A. Palumbo; Nicola Polverelli; Elisabetta Abruzzese; Micaela Bergamaschi; Alessia Tieghi; Mario Tiribelli; Alessandra Iurlo; Francesco Cavazzini; Nicola Sgherza; Gianni Binotto; Alessandro Isidori; Mariella D’Adda; Monica Crugnola; Costanza Bosi; Florian Heidel; Matteo Molica; Luigi Scaffidi; Daniele Cattaneo; Roberto Latagliata; Giuseppe Auteri; Roberto M. Lemoli; Renato Fanin; Domenico Russo; Franco Aversa; Antonio Cuneo; Gianpietro Semenzato; Lucia Catani; Michele Cavo; Nicola Vianelli; Robin Foà; Francesca Palandri
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/670759
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