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.
| Original language | English |
|---|---|
| Pages (from-to) | 889-896 |
| Journal | Annals of Hematology |
| Volume | 98 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2019 |
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Keywords
- BMI
- CCI
- Comorbidities
- Myelofibrosis
- Ruxolitinib
ASJC Scopus subject areas
- Hematology
Cite this
Impact of comorbidities and body mass index in patients with myelofibrosis treated with ruxolitinib. / Breccia, Massimo; Bartoletti, Daniela; Bonifacio, Massimiliano; Palumbo, Giuseppe A.; Polverelli, Nicola; Abruzzese, Elisabetta; Bergamaschi, Micaela; Tieghi, Alessia; Tiribelli, Mario; Iurlo, Alessandra; Cavazzini, Francesco; Sgherza, Nicola; Binotto, Gianni; Isidori, Alessandro; D’Adda, Mariella; Crugnola, Monica; Bosi, Costanza; Heidel, Florian; Molica, Matteo; Scaffidi, Luigi; Cattaneo, Daniele; Latagliata, Roberto; Auteri, Giuseppe; Lemoli, Roberto M.; Fanin, Renato; Russo, Domenico; Aversa, Franco; Cuneo, Antonio; Semenzato, Gianpietro; Catani, Lucia; Cavo, Michele; Vianelli, Nicola; Foà, Robin; Palandri, Francesca.
In: Annals of Hematology, Vol. 98, No. 4, 2019, p. 889-896.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of comorbidities and body mass index in patients with myelofibrosis treated with ruxolitinib
AU - Breccia, Massimo
AU - Bartoletti, Daniela
AU - Bonifacio, Massimiliano
AU - Palumbo, Giuseppe A.
AU - Polverelli, Nicola
AU - Abruzzese, Elisabetta
AU - Bergamaschi, Micaela
AU - Tieghi, Alessia
AU - Tiribelli, Mario
AU - Iurlo, Alessandra
AU - Cavazzini, Francesco
AU - Sgherza, Nicola
AU - Binotto, Gianni
AU - Isidori, Alessandro
AU - D’Adda, Mariella
AU - Crugnola, Monica
AU - Bosi, Costanza
AU - Heidel, Florian
AU - Molica, Matteo
AU - Scaffidi, Luigi
AU - Cattaneo, Daniele
AU - Latagliata, Roberto
AU - Auteri, Giuseppe
AU - Lemoli, Roberto M.
AU - Fanin, Renato
AU - Russo, Domenico
AU - Aversa, Franco
AU - Cuneo, Antonio
AU - Semenzato, Gianpietro
AU - Catani, Lucia
AU - Cavo, Michele
AU - Vianelli, Nicola
AU - Foà, Robin
AU - Palandri, Francesca
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - BMI
KW - CCI
KW - Comorbidities
KW - Myelofibrosis
KW - Ruxolitinib
UR - http://www.scopus.com/inward/record.url?scp=85057972639&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85057972639&partnerID=8YFLogxK
U2 - 10.1007/s00277-018-3569-1
DO - 10.1007/s00277-018-3569-1
M3 - Article
AN - SCOPUS:85057972639
VL - 98
SP - 889
EP - 896
JO - Annals of Hematology
JF - Annals of Hematology
SN - 0939-5555
IS - 4
ER -