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Essential thrombocythemia (ET) is a subtype of BCR::ABL1-negative myeloproliferative neoplasms (MPN), and approximately 50% of patients who are diagnosed with ET are ≥60 years old.1 The MPN Hub have previously reported on a study investigating key considerations in diagnosing and treating pediatric patients with MPN, with specific mention of ET. Below, the MPN Hub describes a retrospective analysis evaluating older patients (≥60 years) and the potential need for different treatment strategies and prognosis compared with younger patients (18-59).
This retrospective, real-world analysis compared the differences in the molecular characteristics, risk factors for complications and disease progression, and current treatment status of patients diagnosed with ET from China.1 Eligible patients:
Selected baseline characteristics of older patients with ET are shown in Table 1.
Table 1. Baseline characteristics*
Characteristics, % (unless otherwise specified) |
Hydroxyurea treatment (n = 160) |
Interferon α treatment (n = 31) |
---|---|---|
Sex |
||
Female |
51.3 |
38.7 |
Male |
48.8 |
61.3 |
Median age (range), years |
67 (60–91) |
65 (60–77) |
Median WBC (range), x109/L |
10.3 (4.5–27.1) |
11.34 (5.24–25.7) |
Driver mutations |
||
JAK2V617F |
67.5 |
64.5 |
CALR |
14.4 |
9.7 |
MPL |
2.5 |
6.5 |
L, liter; WBC, white blood count. *Adapted from Fu, et al.1 |
A total of 903 patients were included in the analysis, of which 282 patients were aged ≥60 years and 621 patients were aged between 18-59 years acting as the control population. Older patients (≥60 years):
Figure 1. Genetic mutation profile of patients aged ≥60 years compared with control group*
RNA, ribonucleic acid.
*Adapted from Fu R, et al.1
Among the patients aged ≥60:
According to the National Comprehensive Cancer Network, all patients who are at high-risk for ET should receive cytoreductive therapy combined with antiplatelet drugs.
This study suggests that patients diagnosed with ET who were aged ≥60 years have different clinical characteristics, molecular profiles, thrombotic and bleeding complications, and prognoses compared with patients aged 18-59 years. These findings indicate that older patients may benefit from different treatment regimens than younger patients and highlights the need for further studies and reviews of clinical practice in this population.
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