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Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States

Myelofibrosis (MF) is a chronic myeloproliferative neoplasm with a prevalence of 4 to 6 per 100,000 people in the USA. Treatment recommendations are risk-adapted. This study was conducted to evaluate how physicians risk-stratify patients at the time of MF diagnosis, the accuracy of the risk stratifi...

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Autores principales: Verstovsek, Srdan, Yu, Jingbo, Kish, Jonathan K., Paranagama, Dilan, Kaufman, Jill, Myerscough, Callan, Grunwald, Michael R., Colucci, Philomena, Mesa, Ruben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536164/
https://www.ncbi.nlm.nih.gov/pubmed/32382773
http://dx.doi.org/10.1007/s00277-020-04055-w
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author Verstovsek, Srdan
Yu, Jingbo
Kish, Jonathan K.
Paranagama, Dilan
Kaufman, Jill
Myerscough, Callan
Grunwald, Michael R.
Colucci, Philomena
Mesa, Ruben
author_facet Verstovsek, Srdan
Yu, Jingbo
Kish, Jonathan K.
Paranagama, Dilan
Kaufman, Jill
Myerscough, Callan
Grunwald, Michael R.
Colucci, Philomena
Mesa, Ruben
author_sort Verstovsek, Srdan
collection PubMed
description Myelofibrosis (MF) is a chronic myeloproliferative neoplasm with a prevalence of 4 to 6 per 100,000 people in the USA. Treatment recommendations are risk-adapted. This study was conducted to evaluate how physicians risk-stratify patients at the time of MF diagnosis, the accuracy of the risk stratification, and its effect on treatment selection. Medical charts were reviewed at US community hematology/oncology practices in the Cardinal Health Oncology Provider Extended Network; patient clinical characteristics, risk stratification, and treatment data were collected. Physician-assigned risk categorizations were compared with data-derived risk categorizations based on the International Prognostic Scoring System, the system recommended at diagnosis. A total of 491 patients diagnosed with MF between 2012 and 2016 (mean [SD] age at diagnosis, 65.4 [11.8] years; 54.8% male, 69.2% with primary MF) were included. Risk categorization was not assigned for 30.1% of patients. Of the patients with a physician-assigned risk categorization (n = 343), a scoring system was used in 49.9%. Compared with data-derived risk categorizations, 42.9% of physician-assigned risk categorizations were incorrect; 85.0% of incorrect physician-assigned risk categorizations were underestimations. Notably, 38.5% of patients with data-derived intermediate- or high-risk categorizations did not initiate treatment within 120 days of diagnosis. Among patients with data-derived intermediate risk, those with an underestimated physician-assigned risk categorization were significantly less likely to receive treatment within 120 days of diagnosis (51.6% with correct physician-assigned categorization vs 18.5% with underestimated risk categorization; P = 0.0023). These results highlight the gap in risk assessment and the importance of accurate risk stratification at diagnosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00277-020-04055-w) contains supplementary material, which is available to authorized users.
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spelling pubmed-75361642020-10-19 Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States Verstovsek, Srdan Yu, Jingbo Kish, Jonathan K. Paranagama, Dilan Kaufman, Jill Myerscough, Callan Grunwald, Michael R. Colucci, Philomena Mesa, Ruben Ann Hematol Original Article Myelofibrosis (MF) is a chronic myeloproliferative neoplasm with a prevalence of 4 to 6 per 100,000 people in the USA. Treatment recommendations are risk-adapted. This study was conducted to evaluate how physicians risk-stratify patients at the time of MF diagnosis, the accuracy of the risk stratification, and its effect on treatment selection. Medical charts were reviewed at US community hematology/oncology practices in the Cardinal Health Oncology Provider Extended Network; patient clinical characteristics, risk stratification, and treatment data were collected. Physician-assigned risk categorizations were compared with data-derived risk categorizations based on the International Prognostic Scoring System, the system recommended at diagnosis. A total of 491 patients diagnosed with MF between 2012 and 2016 (mean [SD] age at diagnosis, 65.4 [11.8] years; 54.8% male, 69.2% with primary MF) were included. Risk categorization was not assigned for 30.1% of patients. Of the patients with a physician-assigned risk categorization (n = 343), a scoring system was used in 49.9%. Compared with data-derived risk categorizations, 42.9% of physician-assigned risk categorizations were incorrect; 85.0% of incorrect physician-assigned risk categorizations were underestimations. Notably, 38.5% of patients with data-derived intermediate- or high-risk categorizations did not initiate treatment within 120 days of diagnosis. Among patients with data-derived intermediate risk, those with an underestimated physician-assigned risk categorization were significantly less likely to receive treatment within 120 days of diagnosis (51.6% with correct physician-assigned categorization vs 18.5% with underestimated risk categorization; P = 0.0023). These results highlight the gap in risk assessment and the importance of accurate risk stratification at diagnosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00277-020-04055-w) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-05-07 2020 /pmc/articles/PMC7536164/ /pubmed/32382773 http://dx.doi.org/10.1007/s00277-020-04055-w Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Verstovsek, Srdan
Yu, Jingbo
Kish, Jonathan K.
Paranagama, Dilan
Kaufman, Jill
Myerscough, Callan
Grunwald, Michael R.
Colucci, Philomena
Mesa, Ruben
Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States
title Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States
title_full Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States
title_fullStr Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States
title_full_unstemmed Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States
title_short Real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the United States
title_sort real-world risk assessment and treatment initiation among patients with myelofibrosis at community oncology practices in the united states
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536164/
https://www.ncbi.nlm.nih.gov/pubmed/32382773
http://dx.doi.org/10.1007/s00277-020-04055-w
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