Age at Myeloproliferative Neoplasm Diagnosis Has Little Impact on Mortality Risk Says New Study

According to a publication from Oncology Nurse Advisor, a study of 109 patients with myeloproliferative neoplasms (certain types of blood cancers) found that mortality rates for younger patients were similar to historical controls for older patients.

The results suggest that a myeloproliferative neoplasm patient’s age may have less impact on their prognosis than initially believed.

About Myeloproliferative Neoplasms

Myeloproliferative neoplasms (MPNs, formerly known as myeloproliferative diseases) are blood cancers characterized by the overproduction of white blood cells or platelets. When produced in quantities beyond the healthy range, the concentrations of these blood cells throughout the bloodstream can affect blood flow.

There are three main subtypes of MPN – polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF). Certain types of leukemia are also considered to be MPNs.

Symptoms and areas affected vary from type to type. Polycythemia vera, for example, causes an overproduction of red blood cells (and sometimes other types of blood cell) that can thicken the blood and slow its flow. Myelofibrosis, on the other hand, is a scarring of the bone marrow that can develop either independently or from some other condition – including other MPNs.

Regardless of Age, MPNs Deadly

A new study published in the European Journal of Haematology followed 109 young adults (aged 18 to 45) with various types of myeloproliferative neoplasms were followed-up with for periods of up to (on average) eight years.

Half of the patients were diagnosed with essential thrombocythemia, 34% with polycythemia vera, 14% with primary myelofibrosis, and 3% with an unspecified myeloproliferative neoplasm.

Though a few experimental inconsistencies existed between the various subgroups in the study (the median age for PV diagnosis was 38 years old, seven years older than the average age of the ET and MF cohorts), it was the consistencies between the younger MPN patients being examined and historical controls that intrigued researchers.

37% of the 109 participants would experience one or more thrombotic (clotting) events, with under 25% experiencing arterial clots. This relatively low number of arterial clots surprised scientists, since in other studies arterial thrombotic events were more common than their venous counterparts. Researchers reasoned that this reduction in arterial thrombosis was due to lower rates of certain arterial risk factors like diabetes or hypertension in younger people.

However, the researchers noted that mortality rates and the aggression of MPNs are consistent between the study group and historical comparisons. They reasoned that the mortality rate similarities were likely, ironically, because younger patients lived long enough for the disease to progress to more advanced stages.

Simply put, younger people have longer to live and thrombotic events (including serious ones in the arteries or spleen) are common in MPN patients. The longer you live, the greater your risk of developing a serious complication, thereby offsetting any health advantage age might otherwise provide you.

Like in any good study, the participating researchers identified and acknowledged their limitations – including the lack of an “older” (presumably 45+) cohort and a “retrospective design.”

Myeloproliferative neoplasms are rare, but can be deadly. Why is it helpful to understand how MPNs progress across different conditions and age groups? Share your thoughts with Patient Worthy!

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