13 results on '"Pérez Encinas, M."'
Search Results
2. Predictors of thrombosis and bleeding in 1613 myelofibrosis patients from the Spanish Registry of Myelofibrosis.
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Hernández-Boluda JC, Pastor-Galán I, Arellano-Rodrigo E, Raya JM, Pérez-Encinas M, Ayala R, Ferrer-Marín F, Velez P, Mora E, Fox ML, Hernández-Rivas JM, Xicoy B, Mata-Vázquez MI, García-Fortes M, Pérez-López R, Angona A, Cuevas B, Senín A, Ramírez MJ, Ramírez-Payer A, Gómez-Casares MT, Martínez-Valverde C, Magro E, Steegmann JL, Durán MA, García-Hernández C, Gasior M, de Villambrosia SG, Alvarez-Larrán A, and Pereira A
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- Humans, Hemorrhage diagnosis, Registries, Risk Factors, Primary Myelofibrosis complications, Primary Myelofibrosis drug therapy, Primary Myelofibrosis genetics, Thrombocythemia, Essential genetics, Thrombosis epidemiology, Thrombosis etiology, Thrombosis diagnosis
- Abstract
Available data have proved insufficient to develop consensus recommendations on the prevention of thrombosis and bleeding in myelofibrosis (MF). We evaluated the incidence and risk factors of vascular complications in 1613 patients from the Spanish Myelofibrosis Registry. Over a total of 6981 patient-years at risk, 6.4% of the study population had at least one thrombotic event after MF diagnosis, amounting to an incidence rate of 1.65 per 100 patient-years. Prior history of thrombosis, the JAK2 mutation, and the intermediate-2/high-risk International Prognostic Scoring System (IPSS) categories conferred an increased thrombotic risk after adjustment for the risk-modifying effect of anti-thrombotic and cytoreductive treatments. History of thrombosis and the JAK2 mutation allowed us to pinpoint a group of patients at higher risk of early thrombosis. No decreased incidence of thrombosis was observed while patients were on anti-thrombotic or cytoreductive treatment. An increased risk of venous thrombosis was found during treatment with immunomodulatory agents. A total of 5.3% of patients had at least one episode of major bleeding, resulting in an incidence rate of 1.5 events per 100 patient-years. Patients in the intermediate-2/high-risk IPSS categories treated with anti-coagulants had an almost sevenfold increased risk of major bleeding. These findings should prove useful for guiding decision-making in clinical practice., (© 2022 British Society for Haematology and John Wiley & Sons Ltd.)
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- 2022
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3. Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera.
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Triguero A, Pedraza A, Pérez-Encinas M, Mata-Vázquez MI, Vélez P, Fox L, Gómez-Calafat M, García-Delgado R, Gasior M, Ferrer-Marín F, García-Gutiérrez V, Angona A, Gómez-Casares MT, Cuevas B, Martínez C, Pérez R, Raya JM, Guerrero L, Murillo I, Bellosillo B, Hernández-Boluda JC, Sanz C, and Álvarez-Larrán A
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- Humans, Middle Aged, Phlebotomy adverse effects, Registries, Leukemia, Myeloid, Acute complications, Polycythemia Vera complications, Polycythemia Vera diagnosis, Polycythemia Vera surgery, Primary Myelofibrosis diagnosis, Thrombosis complications, Thrombosis etiology
- Abstract
Hematological control, incidence of complications, and need for cytoreduction were studied in 453 patients with low-risk polycythemia vera (PV) treated with phlebotomies alone. Median hematocrit value decreased from 54% at diagnosis to 45% at 12 months, and adequate hematocrit control over time (< 45%) was observed in 36%, 44%, and 32% of the patients at 6, 12, and 24 months, respectively. More than 5 phlebotomies per year in the maintenance phase were required in 19% of patients. Worsening thrombocytosis, age > 60 years, and microvascular symptoms constituted the main indications for starting cytoreduction. Median duration without initiating cytoreduction was significantly longer in patients younger than 50 years (< 0.0001). The incidence rate of thrombosis under phlebotomies alone was 0.8% per year and the estimated probability of thrombosis at 10 years was 8.5%. The probability of arterial thrombosis was significantly higher in patients with arterial hypertension whereas there was a trend to higher risk of venous thrombosis in cases with high JAK2V617F allele burden. Rates of major bleeding and second primary neoplasm were low. With a median follow-up of 9 years, survival probability at 10 years was 97%, whereas the probability of myelofibrosis at 10 and 20 years was 7% and 20%, respectively. Progression to acute myeloid leukemia was documented in 3 cases (1%). Current management of low-risk PV patients is associated with low rate of thrombosis and long survival. New treatment strategies are needed for improving hematological control and, in the long term, reducing progression to myelofibrosis., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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4. Real-world analysis of main clinical outcomes in patients with polycythemia vera treated with ruxolitinib or best available therapy after developing resistance/intolerance to hydroxyurea.
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Alvarez-Larrán A, Garrote M, Ferrer-Marín F, Pérez-Encinas M, Mata-Vazquez MI, Bellosillo B, Arellano-Rodrigo E, Gómez M, García R, García-Gutiérrez V, Gasior M, Cuevas B, Angona A, Gómez-Casares MT, Martínez CM, Magro E, Ayala R, Del Orbe-Barreto R, Pérez-López R, Fox ML, Raya JM, Guerrero L, García-Hernández C, Caballero G, Murillo I, Xicoy B, Ramírez MJ, Carreño-Tarragona G, Hernández-Boluda JC, and Pereira A
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- Hemorrhage chemically induced, Humans, Hydroxyurea adverse effects, Nitriles, Pyrazoles, Pyrimidines, Retrospective Studies, Leukemia, Myeloid, Acute drug therapy, Neoplasms, Second Primary drug therapy, Polycythemia Vera drug therapy, Primary Myelofibrosis drug therapy, Thrombosis chemically induced, Thrombosis drug therapy, Thrombosis prevention & control
- Abstract
Background: Ruxolitinib is approved for patients with polycythemia vera (PV) who are resistant/intolerant to hydroxyurea, but its impact on preventing thrombosis or disease-progression is unknown., Methods: A retrospective, real-world analysis was performed on the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to subsequent treatment with ruxolitinib (n = 105) or the best available therapy (BAT; n = 272). Survival probabilities and rates of thrombosis, hemorrhage, acute myeloid leukemia, myelofibrosis, and second primary cancers were calculated according to treatment. To minimize biases in treatment allocation, all results were adjusted by a propensity score for receiving ruxolitinib or BAT., Results: Patients receiving ruxolitinib had a significantly lower rate of arterial thrombosis than those on BAT (0.4% vs 2.3% per year; P = .03), and this persisted as a trend after adjustment for the propensity to have received the drug (incidence rate ratio, 0.18; 95% confidence interval, 0.02-1.3; P = .09). There were no significant differences in the rates of venous thrombosis (0.8% and 1.1% for ruxolitinib and BAT, respectively; P = .7) and major bleeding (0.8% and 0.9%, respectively; P = .9). Ruxolitinib exposure was not associated with a higher rate of second primary cancers, including all types of neoplasia, noncutaneous cancers, and nonmelanoma skin cancers. After a median follow-up of 3.5 years, there were no differences in survival or progression to acute leukemia or myelofibrosis between the 2 groups., Conclusions: The results suggest that ruxolitinib treatment for PV patients with resistance/intolerance to hydroxyurea may reduce the incidence of arterial thrombosis., Lay Summary: Ruxolitinib is better than other available therapies in achieving hematocrit control and symptom relief in patients with polycythemia vera who are resistant/intolerant to hydroxyurea, but we still do not know whether ruxolitinib provides an additional benefit in preventing thrombosis or disease progression. We retrospectively studied the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to whether they subsequently received ruxolitinib (n = 105) or the best available therapy (n = 272). Our findings suggest that ruxolitinib could reduce the incidence of arterial thrombosis, but a disease-modifying effect could not be demonstrated for ruxolitinib in this patient population., (© 2022 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)
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- 2022
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5. Predicting Survival after Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis: Performance of the Myelofibrosis Transplant Scoring System (MTSS) and Development of a New Prognostic Model.
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Hernández-Boluda JC, Pereira A, Alvarez-Larran A, Martín AA, Benzaquen A, Aguirre L, Mora E, González P, Mora J, Dorado N, Sampol A, García-Gutiérrez V, López-Godino O, Fox ML, Reguera JL, Pérez-Encinas M, Pascual MJ, Xicoy B, Parody R, González-Pinedo L, Español I, Avendaño A, Correa JG, Vallejo C, Jurado M, García-Cadenas I, Osorio S, Durán MA, Sánchez-Guijo F, Cervantes F, and Piñana JL
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- Humans, Prognosis, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation, Primary Myelofibrosis therapy
- Abstract
Accurate prognostic tools are crucial to assess the risk/benefit ratio of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with myelofibrosis (MF). We aimed to evaluate the performance of the Myelofibrosis Transplant Scoring System (MTSS) and identify risk factors for survival in a multicenter series of 197 patients with MF undergoing allo-HCT. After a median follow-up of 3.1 years, 47% of patients had died, and the estimated 5-year survival rate was 51%. Projected 5-year risk of nonrelapse mortality and relapse incidence was 30% and 20%, respectively. Factors independently associated with increased mortality were a hematopoietic cell transplantation-specific comorbidity index (HCT-CI) ≥3 and receiving a graft from an HLA-mismatched unrelated donor or cord blood, whereas post-transplant cyclophosphamide (PT-Cy) was associated with improved survival. Donor type was the only parameter included in the MTSS model with independent prognostic value for survival. According to the MTSS, 3-year survival was 62%, 66%, 37%, and 17% for low-, intermediate-, high-, and very high-risk groups, respectively. By pooling together the low- and intermediate-risk groups, as well as the high- and very high-risk groups, we pinpointed 2 categories: standard risk and high risk (25% of the series). Three-year survival was 62% in standard-risk and 25% in high-risk categories (P < .001). We derived a risk score based on the 3 independent risk factors for survival in our series (donor type, HCT-CI, and PT-Cy). The corresponding 5-year survival for the low-, intermediate-, and high-risk categories was 79%, 55%, and 32%, respectively (P < .001). In conclusion, the MTSS model failed to clearly delineate 4 prognostic groups in our series but may still be useful to identify a subset of patients with poor outcome. We provide a simple prognostic scoring system for risk/benefit considerations before transplantation in patients with MF., (Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
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- 2020
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6. Clinico-biological characteristics of patients with myelofibrosis: an analysis of 1,000 cases from the Spanish Registry of Myelofibrosis.
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Pastor-Galán I, Hernández-Boluda JC, Correa JG, Alvarez-Larrán A, Ferrer-Marín F, Raya JM, Ayala R, Velez P, Pérez-Encinas M, Estrada N, García-Gutiérrez V, Fox ML, Payer A, Kerguelen A, Cuevas B, Durán MA, Ramírez MJ, Gómez-Casares MT, Mata-Vázquez MI, Mora E, Martínez-Valverde C, Arbelo E, Angona A, Magro E, Antelo ML, Somolinos N, and Cervantes F
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- Aged, Humans, Prognosis, Registries, Spain epidemiology, Splenomegaly, Primary Myelofibrosis diagnosis, Primary Myelofibrosis epidemiology
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BACKGROUND AND OBJECTIVE MYELOFIBROSIS: is an infrequent chronic myeloproliferative neoplasm. We aimed to describe the clinico-biological characteristics, treatment, and evolutive course of myelofibrosis patients in Spain., Material and Methods: A total of 1,000 patients from the Spanish Registry of Myelofibrosis diagnosed with primary (n=641) or secondary (n=359) myelofibrosis were analysed., Results: Median age was 68 years. The frequency of constitutional symptoms, moderate to severe anaemia (Hb<10g/dL), and symptomatic splenomegaly was 35%, 36%, and 17%, respectively. The rate of thrombosis and haemorrhage was 1.96 and 1.6 events per 100 patient-years, respectively. The cumulative incidence of leukaemia at 10 years was 15%. The most frequent therapies for the anaemia were the erythropoiesis stimulating agents and danazol. From 2010, a progressive increase in the use of ruxolitinib was noticed. A total of 7.5% of patients were transplanted. During the observation period, 42% of patients died mainly due to the clinical deterioration caused by myelofibrosis or leukaemic transformation. The median survival of the series was 5.7 years. Four different risk categories were identified by the IPSS: median survival was not reached in the low risk group and was 8.8 years, 5.3 years, and 2.8 years in the intermediate-1, intermediate-2, and high-risk groups, respectively., Conclusions: Myelofibrosis is a disabling condition mainly affecting elderly people. Its treatment is mostly driven by symptom control. Despite its clinical heterogeneity, several prognostic models are useful to select candidates for transplantation., (Copyright © 2019 Elsevier España, S.L.U. All rights reserved.)
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- 2020
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7. Essential thrombocythaemia with mutation in MPL : clinicopathological correlation and comparison with JAK 2V617F-mutated and CALR- mutated genotypes.
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Alvarez-Larran A, Martínez D, Arenillas L, Rubio A, Arellano-Rodrigo E, Hernández Boluda JC, Papaleo N, Caballero G, Martínez C, Ferrer-Marín F, Mata MI, Pérez-Encinas M, Durán MA, Alonso JM, Carreño-Tarragona G, Alonso JM, Noya S, Magro E, Pérez R, López-Guerra M, Pastor-Galán I, Cervantes F, Besses C, Colomo L, and Rozman M
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- Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Bone Marrow Examination, Cell Proliferation, Child, DNA Mutational Analysis, Female, Genetic Markers, Genetic Predisposition to Disease, Hemoglobins analysis, Humans, Male, Megakaryocytes pathology, Middle Aged, Phenotype, Platelet Count, Primary Myelofibrosis blood, Primary Myelofibrosis pathology, Prognosis, Thrombocythemia, Essential blood, Thrombocythemia, Essential pathology, Young Adult, Calreticulin genetics, Janus Kinase 2 genetics, Mutation, Primary Myelofibrosis genetics, Receptors, Thrombopoietin genetics, Thrombocythemia, Essential genetics
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Aim: To characterise the clinical and histological features of MPL -mutated essential thrombocythaemia (ET)., Patients and Methods: Bone marrow biopsies of 175 patients with ET were centrally reviewed according to the 2016 WHO classification, including 42 cases with MPL mutation, 98 JAK2 V617F-mutated and 35 CALR -mutated. Clinical and histological features were compared among the three genotypes included in the current 2016 WHO classification and among the different types of MPL mutations., Results: Patients with MPL -mutated ET were significantly older than those with the other genotypes. Haematological values at diagnosis were similar among MPL -mutated and CALR -mutated ET, with both genotypes showing higher platelet counts and lower haemoglobin values than ET with JAK2 V617F genotype. In the bone marrow, the median number of megakaryocytes was higher in MPL and CALR than in JAK2 V617F genotype (16, 19 and 14 megakaryocytes per ×20 power field, respectively, p=0.004). Histological features of prefibrotic myelofibrosis were rarely observed in MPL genotype, whereas sinusoidal hyperplasia, dense clusters of megakaryocytes and reticulin fibrosis were more frequent in CALR -mutated ET, with 11% of such cases fulfilling WHO 2016 histological criteria of prefibrotic myelofibrosis. With a median follow-up of 3.5 years, no significant differences were seen among genotypes regarding survival, vascular complications or myelofibrotic transformation. There were no significant differences in the clinical data or in the histological characteristics depending on the type of MPL mutation., Conclusion: MPL and CALR ET genotypes share clinical and histological characteristics. In contrast to CALR genotype, features of prefibrotic myelofibrosis are uncommon in MPL -mutated ET., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
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- 2018
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8. Prognostic risk models for transplant decision-making in myelofibrosis.
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Hernández-Boluda JC, Pereira A, Correa JG, Alvarez-Larrán A, Ferrer-Marín F, Raya JM, Martínez-López J, Velez P, Pérez-Encinas M, Estrada N, García-Gutiérrez V, Fox ML, Payer A, Kerguelen A, Cuevas B, Durán MA, Ramírez MJ, Gómez-Casares MT, Mata-Vázquez MI, Mora E, Gómez M, and Cervantes F
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- Aged, Female, Humans, Longitudinal Studies, Male, Middle Aged, Primary Myelofibrosis epidemiology, Prognosis, Registries, Risk Factors, Spain epidemiology, Transplantation, Homologous methods, Clinical Decision-Making methods, Primary Myelofibrosis diagnosis, Primary Myelofibrosis therapy, Stem Cell Transplantation methods
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Prognostic models are widely used in clinical practice for transplant decision-making in myelofibrosis (MF). We have compared the performance of the International Prognostic Scoring System (IPSS), dynamic IPSS (DIPSS), and DIPSS-plus in a series of 544 patients with primary or secondary MF aged ≤ 70 years at the time of diagnosis. The median projected survival of the overall series was 9.46 years (95% confidence interval 7.44-10.59). Median survival for the highest risk groups was less than 4 years in the three prognostic models. By contrast, the projected survival for patients in the intermediate-2 categories by the IPSS, DIPSS, and DIPSS-plus was 6.6, 5.6, and 6.5 years, respectively. The number of patients in the intermediate-2 and high-risk categories was smaller in the DIPSS than in the IPSS or the DIPSS-plus. The IPSS and DIPSS-plus were the best models to discriminate between the intermediate-1 and intermediate-2 risk categories, which is a critical cut-off point for patient selection to transplant. Among patients assigned at diagnosis to the intermediate-2 or high-risk groups by the IPSS, DIPSS, and DIPSS-plus, only 17, 21, and 20%, respectively, were subsequently transplanted. In conclusion, in our contemporary series of younger MF patients only the highest risk categories of the current prognostication systems have a median survival below the 5-year threshold recommended for considering transplantation. Patient selection for transplantation can significantly differ depending on which prognostication model is used for disease risk stratification.
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- 2018
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9. Clinical characteristics, prognosis and treatment of myelofibrosis patients with severe thrombocytopenia.
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Hernández-Boluda JC, Correa JG, Alvarez-Larrán A, Ferrer-Marín F, Raya JM, Martínez-López J, Velez P, Pérez-Encinas M, Estrada N, García-Gutiérrez V, Fox ML, Luño E, Kerguelen A, Cuevas B, Durán MA, Ramírez MJ, Gómez-Casares M, Mata-Vázquez MI, Regadera A, Pereira A, and Cervantes F
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- Aged, Disease-Free Survival, Female, Humans, Male, Middle Aged, Spain epidemiology, Survival Rate, Primary Myelofibrosis blood, Primary Myelofibrosis diagnosis, Primary Myelofibrosis mortality, Primary Myelofibrosis therapy, Registries, Thrombocytopenia blood, Thrombocytopenia diagnosis, Thrombocytopenia mortality, Thrombocytopenia therapy
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- 2018
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10. Performance of the myelofibrosis secondary to PV and ET-prognostic model (MYSEC-PM) in a series of 262 patients from the Spanish registry of myelofibrosis.
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Hernández-Boluda JC, Pereira A, Correa JG, Alvarez-Larrán A, Ferrer-Marín F, Raya JM, Martínez-López J, Pérez-Encinas M, Estrada N, Velez P, Fox ML, García-Gutiérrez V, Payer A, Kerguelen A, Cuevas B, Durán MA, Ramírez MJ, Gómez-Casares MT, Mata-Vázquez MI, Mora E, Martínez-Valverde C, Gómez M, and Cervantes F
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- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prognosis, Registries, Polycythemia Vera pathology, Primary Myelofibrosis pathology, Thrombocythemia, Essential pathology
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- 2018
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11. Predictive factors for anemia response to erythropoiesis-stimulating agents in myelofibrosis.
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Hernández-Boluda JC, Correa JG, García-Delgado R, Martínez-López J, Alvarez-Larrán A, Fox ML, García-Gutiérrez V, Pérez-Encinas M, Ferrer-Marín F, Mata-Vázquez MI, Raya JM, Estrada N, García S, Kerguelen A, Durán MA, Albors M, and Cervantes F
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- Aged, Disease-Free Survival, Erythropoietin blood, Female, Ferritins blood, Hematinics adverse effects, Humans, Leukocyte Count, Male, Middle Aged, Sex Factors, Spain epidemiology, Survival Rate, Thrombosis blood, Thrombosis chemically induced, Thrombosis mortality, Anemia blood, Anemia drug therapy, Anemia mortality, Hematinics administration & dosage, Primary Myelofibrosis blood, Primary Myelofibrosis drug therapy, Primary Myelofibrosis mortality
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Objective: Erythropoiesis-stimulating agents (ESAs) are commonly used to treat the anemia of myelofibrosis (MF), but information on the predictors of response is limited., Methods: Results of ESA therapy were analyzed in 163 MF patients with severe anemia, most of whom had inadequate erythropoietin (EPO) levels (<125 U/L) at treatment start., Results: According to the revised criteria of the International Working Group for Myelofibrosis Treatment and Research, anemia response was achieved in 86 patients (53%). Median response duration was 19.3 months. In multivariate analysis, baseline factors associated with a higher response rate were female sex (P=.007), leukocyte count ≥10×10
9 /L (P=.033), and serum ferritin <200 ng/mL (P=.002). Patients with 2 or 3 of the above features had a significantly higher response rate than the remainder (73% vs 28%, respectively; P<.001). Over the 373 patient-years of follow-up on ESA treatment, nine patients developed thrombotic complications (six arterial, three venous), accounting for 2.41 events per 100 patient-years. Survival time from ESA start was longer in anemia responders than in non-responders (P=.011)., Conclusion: Besides the already established predictive value of EPO levels, these data can help to identify which MF patients are more likely to benefit from ESA treatment., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)- Published
- 2017
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12. Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
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Triguero, Ana, Pedraza, Alexandra, Pérez-Encinas, Manuel, Mata-Vázquez, María Isabel, Vélez, Patricia, Fox, Laura, Gómez-Calafat, Montse, García-Delgado, Regina, Gasior, Mercedes, Ferrer-Marín, Francisca, García-Gutiérrez, Valentín, Angona, Anna, Gómez-Casares, María Teresa, Cuevas, Beatriz, Martínez, Clara, Pérez, Raúl, Raya, José María, Guerrero, Lucía, Murillo, Ilda, Bellosillo, Beatriz, Hernández-Boluda, Juan Carlos, Sanz, Cristina, Álvarez-Larrán, Alberto, On behalf of the MPN Spanish Group (GEMFIN), Institut Català de la Salut, [Triguero A, Pedraza A] Hospital Clinic de Barcelona, Barcelona, Spain. [Pérez-Encinas M] Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. [Mata-Vázquez MI] Hospital Costa del Sol, Marbella, Spain. [Vélez P] Hospital del Mar, Barcelona, Spain. [Fox L] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Neoplasms::Neoplasms by Site::Hematologic Neoplasms::Bone Marrow Neoplasms::Polycythemia Vera [DISEASES] ,Correction ,Myelofibrosis ,Otros calificadores::Otros calificadores::/cirugía [Otros calificadores] ,Thrombosis ,Hematology ,General Medicine ,Middle Aged ,Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] ,Polycythemia vera ,Phlebotomies ,Other subheadings::Other subheadings::/surgery [Other subheadings] ,Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Specimen Handling::Blood Specimen Collection::Phlebotomy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Low-risk ,diagnóstico::técnicas y procedimientos diagnósticos::técnicas de laboratorio clínico::manejo de muestras::extracción de muestras sanguíneas::flebotomía [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Leukemia, Myeloid, Acute ,Phlebotomy ,Policitèmia - Cirurgia ,Sagnia - Complicacions ,Primary Myelofibrosis ,neoplasias::neoplasias por localización::neoplasias hematológicas::neoplasias de la médula ósea::policitemia vera [ENFERMEDADES] ,Other subheadings::Other subheadings::/adverse effects [Other subheadings] ,Humans ,Registries ,Polycythemia Vera - Abstract
Myelofibrosis; Phlebotomies; Thrombosis Mielofibrosi; Flebotomies; Trombosi Mielofibrosis; Flebotomías; Trombosis Hematological control, incidence of complications, and need for cytoreduction were studied in 453 patients with low-risk polycythemia vera (PV) treated with phlebotomies alone. Median hematocrit value decreased from 54% at diagnosis to 45% at 12 months, and adequate hematocrit control over time ( 60 years, and microvascular symptoms constituted the main indications for starting cytoreduction. Median duration without initiating cytoreduction was significantly longer in patients younger than 50 years (
- Published
- 2022
13. Real-world analysis of main clinical outcomes in patients with polycythemia vera treated with ruxolitinib or best available therapy after developing resistance/intolerance to hydroxyurea
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Alvarez-Larrán, Alberto, Garrote, Marta, Ferrer-Marín, Francisca, Pérez-Encinas, Manuel, Mata-Vazquez, M Isabel, Bellosillo, Beatriz, Arellano-Rodrigo, Eduardo, Gómez, Montse, García, Regina, García-Gutiérrez, Valentín, Gasior, Mercedes, Cuevas, Beatriz, Angona, Anna, Gómez-Casares, María Teresa, Martínez, Clara M, Magro, Elena, Ayala, Rosa, Del Orbe-Barreto, Rafael, Pérez-López, Raúl, Fox, Maria Laura, Raya, José-María, Guerrero, Lucía, García-Hernández, Carmen, Caballero, Gonzalo, Murillo, Ilda, Xicoy, Blanca, Ramírez, M José, Carreño-Tarragona, Gonzalo, Hernández-Boluda, Juan Carlos, Pereira, Arturo, MPN Spanish Group (Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas), Institut Català de la Salut, [Alvarez-Larrán A, Garrote M] Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain. [Ferrer-Marín F] Hospital Morales Messeguer, Universidad Católica San Antonio de Murcia, Murcia, Centro de Investigación Biomédica en Red de Enfermedades Raras, Murcia, Spain. [Pérez-Encinas M] Hospital Clínico Universitario, Santiago de Compostela, Spain. [Mata-Vazquez MI] Hospital Costa del Sol, Marbella, Spain. [Bellosillo B] Hospital del Mar, Barcelona, Spain. [Fox ML] Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Cancer Research ,Medicaments antineoplàstics - Ús terapèutic ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,Myelofibrosis ,Hemorrhage ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] ,Myeloproliferative neoplasms ,neoplasias::neoplasias por localización::neoplasias hematológicas::neoplasias de la médula ósea::policitemia vera [ENFERMEDADES] ,Nitriles ,Other subheadings::Other subheadings::/adverse effects [Other subheadings] ,Humans ,Hydroxyurea ,Retrospective Studies ,Neoplasms::Neoplasms by Site::Hematologic Neoplasms::Bone Marrow Neoplasms::Polycythemia Vera [DISEASES] ,acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antineoplásicos [COMPUESTOS QUÍMICOS Y DROGAS] ,diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Neoplasms, Second Primary ,Thrombosis ,Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Polycythemia vera ,Leukemia, Myeloid, Acute ,Pyrimidines ,Ruxolitinib ,Oncology ,Policitèmia - Tractament ,Primary Myelofibrosis ,Avaluació de resultats (Assistència sanitària) ,Pyrazoles ,Therapy ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents [CHEMICALS AND DRUGS] - Abstract
Altres ajuts: Novartis. Background: Ruxolitinib is approved for patients with polycythemia vera (PV) who are resistant/intolerant to hydroxyurea, but its impact on preventing thrombosis or disease-progression is unknown. Methods: A retrospective, real-world analysis was performed on the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to subsequent treatment with ruxolitinib (n = 105) or the best available therapy (BAT; n = 272). Survival probabilities and rates of thrombosis, hemorrhage, acute myeloid leukemia, myelofibrosis, and second primary cancers were calculated according to treatment. To minimize biases in treatment allocation, all results were adjusted by a propensity score for receiving ruxolitinib or BAT. Results: Patients receiving ruxolitinib had a significantly lower rate of arterial thrombosis than those on BAT (0.4% vs 2.3% per year; P =.03), and this persisted as a trend after adjustment for the propensity to have received the drug (incidence rate ratio, 0.18; 95% confidence interval, 0.02-1.3; P =.09). There were no significant differences in the rates of venous thrombosis (0.8% and 1.1% for ruxolitinib and BAT, respectively; P =.7) and major bleeding (0.8% and 0.9%, respectively; P =.9). Ruxolitinib exposure was not associated with a higher rate of second primary cancers, including all types of neoplasia, noncutaneous cancers, and nonmelanoma skin cancers. After a median follow-up of 3.5 years, there were no differences in survival or progression to acute leukemia or myelofibrosis between the 2 groups. Conclusions: The results suggest that ruxolitinib treatment for PV patients with resistance/intolerance to hydroxyurea may reduce the incidence of arterial thrombosis. Lay Summary: Ruxolitinib is better than other available therapies in achieving hematocrit control and symptom relief in patients with polycythemia vera who are resistant/intolerant to hydroxyurea, but we still do not know whether ruxolitinib provides an additional benefit in preventing thrombosis or disease progression. We retrospectively studied the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to whether they subsequently received ruxolitinib (n = 105) or the best available therapy (n = 272). Our findings suggest that ruxolitinib could reduce the incidence of arterial thrombosis, but a disease-modifying effect could not be demonstrated for ruxolitinib in this patient population.
- Published
- 2022
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