Does Race Impact Survival in Patients with Philadelphia Chromosome-Negative MPN?

A study published in Hematology/Oncology and Stem Cell Therapy observed no significant difference in the rate of thrombotic or hemorrhagic events between white and non-white patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs); however, non-white patients had significantly shorter median survival than white patients.

The retrospective study included 300 adults with MPN who were seen at the Indiana University Simon Cancer Center between January 1992 and January 2019; 270 patients (90%) were white and 30 (10%) were non-white. The non-white group primarily consisted of African American or Black patients (n=26). Median age at diagnosis was 58.0 years for white patients and 61.5 years for non-white patients.

The incidence of thrombotic events was inversely correlated with age at diagnosis: Younger patients demonstrated a higher rate of thrombotic events over time (P<0.001). A total of 104 vascular events occurred during the study period, including 73 thrombotic and 31 hemorrhagic events. At the time of hemorrhagic events, 14 patients (45%) were on antiplatelet agents, and the rate of patients on antiplatelet therapy was similar among white (45.2%) and non-white (40%) patients.

The incidence of thrombotic (P=0.30) or hemorrhagic (P=0.20) events did not differ between white and non-white patients. However, there was a statistically significant difference in median survival between white (29 years; 95% confidence interval [CI], 21.8 to not reached) and non-white patients (13 years (95% CI, 5.7-22.7; P=0.016).

Among patients who had any event, a larger proportion of non-white patients (44.4%) died compared with white patients (20.7%), although the difference was not statistically significant (P=0.08).

“Such observations may inform future studies to further characterize disparities in outcomes at the socioeconomic level. Future efforts should focus on multicenter collaborations to evaluate the possible role of race or ethnicity in complications and outcomes of patients with MPN and to investigate the underlying causes of any potential disparities,” the researchers concluded.