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Reduced renal function strongly affects survival and thrombosis in patients with myelofibrosis

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Abstract

We retrospectively investigated a cohort of 176 myelofibrosis patients (128 primary-PMF; 48 secondary-SMF) from five hematology centers. The presence of chronic kidney disease (CKD) was determined in addition to other clinical characteristics. CKD was present in 26.1% of MF patients and was significantly associated with older age (P < 0.001), higher WBC (P = 0.015), and its subsets (neutrophil, monocyte, and basophil counts), higher platelets (P = 0.001), lower albumin (P = 0.018), higher serum uric acid (P = 0.001), higher LDH (P = 0.022), and the presence of CV risk factors (P = 0.011). There was no significant association with driver mutations, degree of bone marrow fibrosis, PMF/SMF, or DIPSS risk categories (P > 0.05 for all analyses). The presence of CKD was significantly associated with shorter time to arterial (HR = 3.49; P = 0.041) and venous thrombosis (HR = 7.08; P = 0.030) as well as with shorter overall survival (HR 2.08; P = 0.009). In multivariate analyses, CKD (HR = 1.8; P = 0.014) was associated with shorter survival independently of the DIPSS (HR = 2.7; P < 0.001); its effect being more pronounced in lower (HR = 3.56; P = 0.036) than higher DIPSS categories (HR = 2.07; P = 0.023). MF patients with CKD should be candidates for active management aimed at the improvement of renal function. Prospective studies defining the optimal therapeutic approach are highly needed.

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Authors and Affiliations

  1. Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia

    Marko Lucijanic, Martina Sedinic & Rajko Kusec

  2. Department of Hematology, University Hospital of Split, Soltanska ul. 1, 21000, Split, Croatia

    Davor Galusic

  3. Hematology Department, General Hospital Sibenik, Ul. Stjepana Radića 83, 22000, Sibenik, Croatia

    Ivan Krecak

  4. Department of Internal Medicine, “Dr. Josip Bencevic” General Hospital, Ul. Andrije Štampara, 35000, Slavonski Brod, Croatia

    Hrvoje Holik

  5. Department of Hematology, Osijek University Hospital, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia

    Vlatka Perisa

  6. Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia

    Vlatka Perisa

  7. Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia

    Martina Moric Peric & Ivan Zekanovic

  8. Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia

    Tajana Stoos-Veic

  9. School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia

    Tajana Stoos-Veic & Rajko Kusec

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  1. Marko Lucijanic
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  2. Davor Galusic
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Correspondence to Marko Lucijanic.

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All patients provided written informed consent for molecular analyses. The study was approved by the Institutional review boards. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975

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Lucijanic, M., Galusic, D., Krecak, I. et al. Reduced renal function strongly affects survival and thrombosis in patients with myelofibrosis. Ann Hematol 99, 2779–2785 (2020). https://doi.org/10.1007/s00277-020-04239-4

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