MPN-186 Community Versus Academic Practice in Essential Thrombocythemia and Myelofibrosis: Differences in Clinical Characteristics, Diagnosis, Treatment Patterns, and Symptom Burden: Analysis of Data from the MOST Study.
Academic Article
Overview
abstract
CONTEXT: Myelofibrosis and Essential Thrombocythemia Observational STudy (MOST) (NCT02953704) is an ongoing observational study in essential thrombocythemia (ET) or myelofibrosis (MF) patients enrolled in academic (AC) and community (CC) centers throughout the US. OBJECTIVE: Examine baseline demographics, diagnosis, treatment patterns, and symptom burden in AC versus CC. DESIGN: Longitudinal, prospective, noninterventional. SETTING: 24 AC; 82 CC. PATIENTS: High-risk (≥60 years old and/or thromboembolic history) or low-risk ET (receiving ET-directed therapy, excluding aspirin); ≥18 years old, with low-risk or intermediate-1-risk (INT-1-risk) MF (age >65 years). RESULTS: ET cohort (n=1,182): AC (n=273 [17% low-risk; 83% high-risk]); CC (n=909 [12% low-risk; 88% high-risk]). For AC versus CC, mean age (63.7 vs. 69.2 y), race, ethnicity, education level, and employment status were significantly different (P<0.05); 72.0% of AC versus 60.5% of CC patients had >high school education; 43.2% versus 28.2% were employed. Significantly fewer AC patients were White (84.4% vs. 90.3%) and Hispanic/Latino (4.0% vs. 8.6%) (P<0.05). Of high-risk AC versus CC patients, 78.4% versus 81.5% received ET-directed monotherapy (hydroxyurea, 81.5% vs. 82.3%; interferon, 7.3% vs. 0.9%; anagrelide, 5.6% vs. 12.1%). Among low-risk AC versus CC patients, 95.7% versus 93.6% received ET-directed monotherapy (hydroxyurea, 59.1% vs. 84.5%; interferon, 31.8% vs. 1.0%; anagrelide, 2.3% vs. 11.7%). Significantly more AC versus CC patients had ≥1 ET-related, physician-reported symptom and leukopenia (P<0.05). MF cohort (n=203): AC (n=92 [50% low-risk; 50% INT-1-risk]); CC (n=111 [35% low-risk; 65% INT-1-risk]). For AC versus CC, mean age (65.4 vs. 68.5 y), ethnicity, and education level were significantly different; significantly fewer AC than CC patients were Hispanic/Latino (0% vs. 6.3%) (P<0.05). Of low-risk AC versus CC patients, 60.9% versus 53.8% received MF-directed monotherapy (hydroxyurea, 57.1% vs. 52.4%; interferon, 10.7% vs. 4.8%). Among INT-1-risk AC versus CC patients, 50.0% versus 59.7% received MF-directed monotherapy (hydroxyurea, 17.4% vs. 48.8%; interferon, 30.4% vs. 2.3%). Similar percentages of AC versus CC patients had ≥1 MF-related, physician-reported symptom. CONCLUSIONS: Real-world data demonstrate similar care between AC and CC. The clinical significance of key differences in demographics, disease features, and treatment history remains unclear. Understanding these will help improve disease management across sites. Older and minority populations in CC may represent a key population for clinical trial recruitment.
