BMI, Comorbidities Impact Patients with Polycythemia Vera

A study published in Hematological Oncology found that overweight/obese patients with polycythemia vera (PV) do not have an increased risk of progression to post‐PV myelofibrosis (PPV-MF) or death. However, the number of comorbidities a patient has may impact survival in this patient cohort.

The multicenter, retrospective study included 816 patients with PV. Researchers assessed the predictive value of Charlson Comorbidity Index (CCI) and body mass index (BMI) on thrombosis, progression to PPV‐MF, and survival.

Patients were categorized based on CCI and BMI: CCI 0 (no comorbidities), 58.1%; CCI ≥1, 41.9%; normal/underweight (BMI <25 kg/m2), 54.5%; and overweight/obese (BMI ≥25 kg/m2), 45.5%. BMI data were available for 529 patients.

Patients with CCI ≥1 were older and more commonly presented cardiovascular risk factors compared with patients with CCI 0 (P<0.001). Overweight/obese patients were more commonly male (P<0.001).

At 10 years, cumulative incidence of thromboses with death was 13.3%. Previous thromboses (sub-distribution hazard ratio [SHR], 2.1; P=0.01) and hypertension (SHR, 1.77; P=0.04) were significantly associated with increased thrombotic risk. BMI ≥25 kg/m2 lost statistical significance (SHR, 1.69; P=0.05), and CCI ≥1 was excluded after evaluation of goodness of fit.

After a median follow‐up of 6.1 years, progression to PPV‐MF occurred in 44 patients, and 75 patients died. BMI ≥25 kg/m2 was associated with a lower probability of progression to PPV‐MF (SHR, 0.38; 95% confidence interval [CI], 0.15‐0.94; P=0.04) and better survival (HR, 0.42; 95% CI, 0.18‐0.97; P=0.04). CCI ≥1 did not impact progression to PPV‐MF (P=0.44) or survival (P=0.71). However, CCI ≥2 was associated with reduced survival (HR, 1.81; P=0.03).

“The evaluation of CCI and BMI may improve the prognostic definition of PV,” the researchers concluded.