Survival outcomes and treatment patterns in myelofibrosis in the JAK inhibitor era

Rákkutatás · Myelofibrosis

In a Spanish real‑world cohort of 1,649 patients with myelofibrosis, overall survival was 6.6 years and the 10‑year relative survival was 44 % in the general cohort and only 12 % for high‑risk IPSS patients.

Data on real‑world survival and treatment patterns in large, unselected myelofibrosis (MF) cohorts remain limited. We analysed 1,649 patients with MF diagnosed from 2010 onwards and included in the Spanish Myelofibrosis Registry across 64 centres. Janus kinase (JAK) inhibitors were administered to approximately half of the patients. Among those aged ≥70 years with intermediate‑2/high‑risk International Prognostic Scoring System (IPSS), only 25 % ultimately underwent transplantation. Median survival was 6.6 years, with no significant differences between primary and secondary MF; acute leukaemia was the most frequent cause of death, accounting for 20 % of cases. Compared with a matched general population, relative survival at 5 and 10 years was 68 % and 44 % respectively. The reduction in relative survival was more pronounced in patients aged >65 years and in male patients, two subgroups that also exhibited a higher burden of comorbidities and a greater frequency of high‑molecular‑risk mutations. Remarkably, patients in the high‑risk IPSS category had a 10‑year relative survival of only 12 %; however, survival reduction was not confined to high‑risk disease, with divergence from expected survival emerging early among lower‑risk categories. These findings highlight the persistent impact of MF on life expectancy in the contemporary JAK inhibitor era and the need for improvement in its overall management.

This study demonstrates that myelofibrosis remains associated with markedly reduced life expectancy despite widespread use of JAK inhibitors, underscoring the need for earlier intervention and improved therapeutic strategies.

Bizonyítékszint: Számítógépes vagy elméleti. Modellből vagy adatbányászatból származó jel.

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