Treatment with JAK inhibitors in myelofibrosis patients nullifies the prognostic impact of unfavorable cytogenetics

Publication date: Available online 2 March 2018 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Vincent T. Ma, Philip S. Boonstra, Kamal Menghrajani, Cecelia Perkins, Krisstina L. Gowin, Ruben A. Mesa, Jason R. Gotlib, Moshe Talpaz In the era before the advent of JAK inhibitors, cytogenetic information was used to predict survival in myelofibrosis patients. However, the prognostic value of cytogenetics in the setting of JAK inhibitor therapy remains unknown. We performed a retrospective analysis on 180 patients with bone marrow biopsy-proven myelofibrosis from three US academic medical centers. We fit Cox proportional hazards models for overall survival and transformation-free survival based on three factors: JAK inhibitor therapy as a time-dependent covariate, dichotomized cytogenetic status (favorable vs unfavorable), and statistical interaction between the two. The median follow-up time was 37.1 months. Among patients treated with best available therapy, unfavorable cytogenetics status was associated with decreased survival (HR 2.31; p = 0.025). Upon initiation of JAK inhibitor therapy, unfavorable cytogenetics was (non-significantly) associated with increased survival compared to favorable cytogenetics (HR 0.292; p = 0.172). The ratio of HRs was 0.126 (p = 0.034). These findings were similar after adjusting for standard clinical prognostic factors as well as when measured against transformation-free survival. Overall, the initiation of JAK inhibitor the...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research