Patients with myelofibrosis (MF) may experience worse outcomes after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), according to a study recently published in Therapeutic Advances in Hematology.
“The present study confirmed dismal outcomes in the older [myeloproliferative neoplasm] patients and in those with higher comorbidity burden, (ie, cardiovascular or pulmonary disease or diabetes),” the authors wrote.
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This multicenter, retrospective observational study included 398 patients previously diagnosed with myeloproliferative neoplasms who had coronavirus disease 2019 (COVID-19). The majority (46%) had MF, followed by 28.4% with essential thrombocythemia and 25.6% with polycythemia vera.
Among all the participants, 7.53% received the diagnosis of a myeloproliferative disease at the same time or within a month of COVID-19 diagnosis.
Regarding treatment, 37.2% of the individuals underwent treatment with hydroxyurea and 27.9% received Janus kinase (JAK) inhibitors prior to acquiring SARS-CoV-2 infection. Notably, 55.2% of all participants and 30.4% of participants with MF had been taking immunosuppressive drugs.
Most patients (n=239) presented with severe and/or critical symptoms, 125 of whom had MF. Only 16.6% of the entire cohort was asymptomatic for COVID-19. A marked proportion (54.3%) of all cases, and specifically those with MF (62.3%), required hospitalization, and 7.3% and 8.7% of each group needed invasive ventilation, respectively. Importantly, the mortality rate of the whole group was 22.4% and that of the MF group was 31.1%.
Moreover, the risk of death was independently associated with an age of 70 years or over, previous comorbidities, and exposure to immunosuppressive drugs.
“Specific preventive strategies need, thus, to be tailored for these individuals at risk, including application of potentially protective preventive antibody cocktails as well as mindful tapering strategies in [myeloproliferative neoplasm] patients pretreated with JAK inhibitors,” the authors concluded.
Reference
Marchetti M, Salmanton-García J, El-Ashwah S, et al. Outcomes of SARS-CoV-2 infection in Ph-neg chronic myeloproliferative neoplasms: results from the EPICOVIDEHA registry. Ther Adv Hematol. Published online March 11, 2023. doi:10.1177/20406207231154706
