Indiana University School of Medicine, Department of Medicine, Indianapolis, IN, USA.
Mayo Clinic, Division of Hematology, Department of Medicine, Rochester, MN, USA.
Hematol Oncol Stem Cell Ther. 2022 Jun 1;15(2):30-38. doi: 10.1016/j.hemonc.2021.01.005.
Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) are a group of hematologic malignancies with known vascular complications. The role race and ethnicity play in these complications is less defined. We aimed to further evaluate the role of race in patients without a history of previous thrombotic or hemorrhagic events.
In this retrospective study, 300 adult patients with MPN were included; 270 (90.0%) were White and 30 (10.0%) were non-White. The non-White group primarily consisted of African American or Black (26 patients), followed by others. Median age at diagnosis was 58 years for White patients and 61.5 years for non-White patients. The interaction between outcomes and vascular events with race was evaluated using multivariate logistical regression models.
The incidence of thrombotic events was inversely correlated with age at diagnosis, with younger patients demonstrating a higher rate of thrombotic events over time (p < .001). The incidence of thrombotic or hemorrhagic events did not differ between White and non-White patients. A statistically significant difference in median survival was observed between White and non-White patients: 29 years (95% confidence interval [CI]: 21.8-not reached) versus 13 years (95% CI: 5.7-22.7), respectively (p=.016).
This study did not find a significant difference in the rate of thrombotic or hemorrhagic events between White and non-White patients with MPN but suggested that non-White patients had significantly shorter median survival than White patients. Such observations may inform future studies to further characterize racial disparities in outcomes.
费城染色体阴性骨髓增殖性肿瘤(MPN)是一组已知有血管并发症的血液系统恶性肿瘤。种族在这些并发症中的作用尚未明确。我们旨在进一步评估在无既往血栓或出血事件史的患者中种族的作用。
在这项回顾性研究中,纳入了 300 名 MPN 成年患者;其中 270 名(90.0%)为白人,30 名(10.0%)为非白人。非白人组主要由非裔美国人或黑人(26 例)组成,其次是其他人。白人患者的中位诊断年龄为 58 岁,非白人患者为 61.5 岁。使用多变量逻辑回归模型评估结局与血管事件与种族之间的相互作用。
血栓事件的发生率与诊断时的年龄呈负相关,随着时间的推移,年轻患者的血栓事件发生率更高(p<0.001)。白人患者和非白人患者的血栓或出血事件发生率无差异。白人患者和非白人患者的中位生存期存在统计学显著差异:分别为 29 年(95%可信区间[CI]:21.8-未达到)和 13 年(95%CI:5.7-22.7)(p=0.016)。
本研究未发现 MPN 白人和非白人患者的血栓或出血事件发生率有显著差异,但提示非白人患者的中位生存期明显短于白人患者。这些观察结果可能为进一步描述结局方面的种族差异提供信息。