Risk and cause of death in patients diagnosed with myeloproliferative neoplasms in Sweden between 1973 and 2005: A population-based study Journal Article


Authors: Hultcrantz, M.; Wilkes, S. R.; Kristinsson, S. Y.; Andersson, T. M. L.; Derolf, A. R.; Eloranta, S.; Samuelsson, J.; Landgren, O.; Dickman, P. W.; Lambert, P. C.; Björkholm, M.
Article Title: Risk and cause of death in patients diagnosed with myeloproliferative neoplasms in Sweden between 1973 and 2005: A population-based study
Abstract: Purpose Myeloproliferative neoplasms (MPNs) are associated with a shortened life expectancy. We assessed causes of death in patients with MPN and matched controls using both relative risks and absolute probabilities in the presence of competing risks. Patients and Methods From Swedish registries, we identified 9,285 patients with MPN and 35,769 matched controls. A flexible parametric model was used to estimate cause-specific hazard ratios (HRs) of death and cumulative incidence functions, each with 95% CIs. Results In patients with MPN, the HRs of death from hematologic malignancies and infections were 92.8 (95% CI, 70.0 to 123.1) and 2.7 (95% CI, 2.4 to 3.1), respectively. In patients age 70 to 79 years at diagnosis (the largest patient group), the HRs of death from cardiovascular and cerebrovascular disease were 1.5 (95% CI, 1.4 to 1.7) and 1.5 (95% CI, 1.3 to 1.8), respectively; all were statistically significantly elevated compared with those of controls. In the same age group, no difference was observed in the 10-year probability of death resulting from cardiovascular disease in patients with MPN versus controls (16.8% v 15.2%) or cerebrovascular disease (5.6% v 5.2%). In patients age 50 to 59 years at diagnosis, the 10-year probability of death resulting from cardiovascular and cerebrovascular disease was elevated, 4.2% versus 2.1% and 1.9% versus 0.4%, respectively. Survival in patients with MPN increased over time, mainly because of decreased probabilities of dying as a result of hematologic malignancies, infections, and, in young patients, cardiovascular disease. Conclusion Patients with MPN had an overall higher mortality rate than that of matched controls, primarily because of hematologic malignancy, infections, and vascular events in younger patients. Evidently, there is still a need for effective disease-modifying agents to improve patient outcomes. © 2015 by American Society of Clinical Oncology.
Keywords: adult; cancer survival; controlled study; aged; middle aged; myelofibrosis; major clinical study; cancer risk; solid tumor; cancer incidence; infection; lung disease; cancer mortality; groups by age; risk assessment; sweden; cause of death; population research; hematologic malignancy; myelodysplastic syndrome; cardiovascular disease; cerebrovascular disease; vein thrombosis; dementia; heart arrhythmia; life expectancy; congestive heart failure; myeloproliferative neoplasm; cardiovascular mortality; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 33
Issue: 20
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2015-07-10
Start Page: 2288
End Page: 2295
Language: English
DOI: 10.1200/jco.2014.57.6652
PROVIDER: scopus
PUBMED: 26033810
DOI/URL:
Notes: Export Date: 2 October 2015 -- Source: Scopus
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MSK Authors
  1. Carl Ola Landgren
    175 Landgren