Predictive factors for anemia response to erythropoiesis-stimulating agents in myelofibrosis.

Abstract

OBJECTIVE:

Erythropoiesis-stimulating agents (ESAs) are commonly used to treat the anemia of myelofibrosis (MF), but information on the predictors of response is limited.

METHODS:

Results of ESA therapy were analyzed in 163 MF patients with severe anemia, most of whom had inadequate erythropoietin (EPO) levels (<125 U/L) at treatment start.

RESULTS:

According to the revised criteria of the International Working Group for Myelofibrosis Treatment and Research, anemia response was achieved in 86 patients (53%). Median response duration was 19.3 months. In multivariate analysis, baseline factors associated with a higher response rate were female sex (P=.007), leukocyte count ≥10×109 /L (P=.033), and serum ferritin <200 ng/mL (P=.002). Patients with 2 or 3 of the above features had a significantly higher response rate than the remainder (73% vs 28%, respectively; P<.001). Over the 373 patient-years of follow-up on ESA treatment, nine patients developed thrombotic complications (six arterial, three venous), accounting for 2.41 events per 100 patient-years. Survival time from ESA start was longer in anemia responders than in non-responders (P=.011).

CONCLUSION:

Besides the already established predictive value of EPO levels, these data can help to identify which MF patients are more likely to benefit from ESA treatment.

• Authors: Juan-Carlos Hernández-Boluda, Juan-Gonzalo Correa, Regina García-Delgado, Joaquín Martínez-López, Alberto Alvarez-Larrán, María-Laura Fox, Valentín García-Gutiérrez, Manuel Pérez-Encinas, Francisca Ferrer-Marín, María-Isabel Mata-Vázquez, José-María Raya, Natalia Estrada, Silvia García, Ana Kerguelen, María-Antonia Durán, Manuel Albors, Francisco Cervantes
• Journal: European journal of haematology (Eur J Haematol) Vol. 98 Issue 4 Pg. 407-414 (Apr 2017) ISSN: 1600-0609 [Electronic] England
• PMID: 28009442 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
• Copyright: © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• EPO protein, human
• Hematinics
• Erythropoietin
• Ferritins

Topics

• Aged
• Anemia (blood, drug therapy, mortality)
• Disease-Free Survival
• Erythropoietin (blood)
• Female
• Ferritins (blood)
• Hematinics (administration & dosage, adverse effects)
• Humans
• Leukocyte Count
• Male
• Middle Aged
• Primary Myelofibrosis (blood, drug therapy, mortality)
• Sex Factors
• Spain (epidemiology)
• Survival Rate
• Thrombosis (blood, chemically induced, mortality)