Reduced renal function strongly affects survival and thrombosis in patients with myelofibrosis

Scientific paper - Original scientific paper

• Author: Marko Lucijanić
• Author: Davor Galušić
• Author: Ivan Krečak
• Author: Martina Sedinić
• Author: Hrvoje Holik
• Author: Vlatka Periša
• Author: Martina Morić Perić
• Author: Ivan Zekanović
• Author: Tajana Štoos-Veić
• Author: Rajko Kušec
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

We retrospectively investigated a cohort of 176 myelofibrosis patients (128 primary-PMF; 48 secondary-SMF) from five hematology centers. The presence of chronic kidney disease (CKD) was determined in addition to other clinical characteristics. CKD was present in 26.1% of MF patients and was significantly associated with older age (P < 0.001), higher WBC (P = 0.015), and its subsets (neutrophil, monocyte, and basophil counts), higher platelets (P = 0.001), lower albumin (P = 0.018), higher serum uric acid (P = 0.001), higher LDH (P = 0.022), and the presence of CV risk factors (P = 0.011). There was no significant association with driver mutations, degree of bone marrow fibrosis, PMF/SMF, or DIPSS risk categories (P > 0.05 for all analyses). The presence of CKD was significantly associated with shorter time to arterial (HR = 3.49; P = 0.041) and venous thrombosis (HR = 7.08; P = 0.030) as well as with shorter overall survival (HR 2.08; P = 0.009). In multivariate analyses, CKD (HR = 1.8; P = 0.014) was associated with shorter survival independently of the DIPSS (HR = 2.7; P < 0.001); its effect being more pronounced in lower (HR = 3.56; P = 0.036) than higher DIPSS categories (HR = 2.07; P = 0.023). MF patients with CKD should be candidates for active management aimed at the improvement of renal function. Prospective studies defining the optimal therapeutic approach are highly needed.

• Keywords (english): Aged; Cohort Studies; Female; Glomerular Filtration Rate / physiology; Humans; Kidney / physiology; Male; Middle Aged; Primary Myelofibrosis / diagnosis; Primary Myelofibrosis / mortality; Primary Myelofibrosis / physiopathology; Renal Insufficiency, Chronic / diagnosis; Renal Insufficiency, Chronic / mortality; Renal Insufficiency, Chronic / physiopathology; Retrospective Studies; Survival Rate / trends; Thrombosis / diagnosis; Thrombosis / mortality; Thrombosis / physiopathology
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Annals of Hematology
• Numbering: vol. 99, no. 12, pp. 2779-2785
• p-ISSN: 0939-5555
• e-ISSN: 1432-0584
• DOI: https://doi.org/10.1007/s00277-020-04239-4
• URN:NBN: urn:nbn:hr:105:588865
• Publication: 2020-12
• Document URL: http://link.springer.com/10.1007/s00277-020-04239-4
• Type of resource: Text
• Access conditions: Open access; Embargo expiration date: 2022-01-01
• Created on: 2021-05-18 09:36:17