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High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib

2021; Springer Nature; Volume: 35; Issue: 2 Linguagem: Inglês

10.1038/s41375-020-01107-y

1476-5551

Tiziano Barbui, Alessandro M. Vannucchi, Alberto Álvarez‐Larrán, Alessandra Iurlo, Arianna Masciulli, Alessandra Carobbio, Arianna Ghirardi, Alberto Ferrari, Giuseppe Rossi, Elena Maria Elli, Marcio Andrade‐Campos, Mercedes Gasior Kabat, Jean-Jaques Kiladjian, Francesca Palandri, Giulia Benevolo, Valentín García‐Gutiérrez, María Laura Fox, María Ángeles Foncillas, Carmen Morcillo, Elisa Rumi, Santiago Osorio, Petros Papadopoulos, Massimiliano Bonifacio, Keina Quiroz Cervantes, Miguel Sagüés Serrano, Gonzalo Carreño‐Tarragona, Marta Sobas, Francesca Lunghi, Andrea Patriarca, Begoña Navas Elorza, Anna Angona, Elena Magro Mazo, Steffen Koschmieder, Marco Ruggeri, Beatriz Cuevas, Juan Carlos Hernández‐Boluda, Emma Lopez Abadia, Blanca Xicoy Cirici, Paola Guglielmelli, Marta Garrote, Daniele Cattaneo, Rosa Daffini, Fabrizio Cavalca, Beatríz Bellosillo, Lina Benajiba, Natalia Curto‐García, Marta Bellini, Silvia Betti, Valerio De Stefano, Claire Harrison, Alessandro Rambaldi,

Chronic Myeloid Leukemia Treatments

We report the clinical presentation and risk factors for survival in 175 patients with myeloproliferative neoplasms (MPN) and COVID-19, diagnosed between February and June 2020. After a median follow-up of 50 days, mortality was higher than in the general population and reached 48% in myelofibrosis (MF). Univariate analysis, showed a significant relationship between death and age, male gender, decreased lymphocyte counts, need for respiratory support, comorbidities and diagnosis of MF, while no association with essential thrombocythemia (ET), polycythemia vera (PV), and prefibrotic-PMF (pre-PMF) was found. Regarding MPN-directed therapy ongoing at the time of COVID-19 diagnosis, Ruxolitinib (Ruxo) was significantly more frequent in patients who died in comparison with survivors (p = 0.006). Conversely, multivariable analysis found no effect of Ruxo alone on mortality, but highlighted an increased risk of death in the 11 out of 45 patients who discontinued treatment. These findings were also confirmed in a propensity score matching analysis. In conclusion, we found a high risk of mortality during COVID-19 infection among MPN patients, especially in MF patients and/or discontinuing Ruxo at COVID-19 diagnosis. These findings call for deeper investigation on the role of Ruxo treatment and its interruption, in affecting mortality in MPN patients with COVID-19.