期刊
LEUKEMIA
卷 35, 期 9, 页码 2592-2601出版社
SPRINGERNATURE
DOI: 10.1038/s41375-021-01183-8
关键词
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资金
- David L. Johns Family of the Cancer Research & Treatment Fund (CRT)
- Myeloproliferative Neoplasms Research Foundation (MPN-RF)
- Clinical & Translational Science Center (CTSC) of Weill Cornell
- National Center for Advancing Translational Sciences (NCATS) [1 UL1 TR002384-04]
The study suggests that treatment of PV with rIFN alpha can reduce the risk of myelofibrosis and mortality, especially in high-risk patients.
Interferon-alpha (rIFN alpha) is the only disease-modifying treatment for polycythemia vera (PV), but whether or not it prolongs survival is unknown. This large single center retrospective study of 470 PV patients compares the myelofibrosis-free survival (MFS) and overall survival (OS) with rIFN alpha to two other primary treatments, hydroxyurea (HU) and phlebotomy-only (PHL-O). The median age at diagnosis was 54 years (range 20-94) and the median follow-up was 10 years (range 0-45). Two hundred and twenty-nine patients were women (49%) and 208 were high-risk (44%). The primary treatment was rIFN alpha in 93 (20%), HU in 189 (40%), PHL-O in 133 (28%) and other cytoreductive drugs in 55 (12%). The treatment groups differed by ELN risk score (p < 0.001). In low-risk patients, 20-year MFS for rIFN alpha, HU, and PHL-O was 84%, 65% and 55% respectively (p < 0.001) and 20-year OS was 100%, 85% and 80% respectively (p = 0.44). In high-risk patients, 20-year MFS for rIFN alpha, HU, and PHL-O was 89%, 41% and 36% respectively (p = 0.19) and 20-year OS was 66%, 40%, 14% respectively (p = 0.016). In multivariable analysis, longer time on rIFN alpha was associated with a lower risk of myelofibrosis (HR: 0.91, p < 0.001) and lower mortality (HR: 0.94, p = 0.012). In conclusion, this study supports treatment of PV with rIFN alpha to prevent myelofibrosis and potentially prolong survival.
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