Real-world status of treatment for lymphoid neoplasms developed during the course of myeloproliferative neoplasms in Japan

ABSTRACT

Objectives:

Patients with myeloproliferative neoplasms (MPNs) are at higher risk of developing secondary malignancies. In this study, we focused on patients with MPNs that complicated lymphoid neoplasms. To analyze the real-world status of lymphoid neoplasm treatment in patients with pre-existing MPNs in Japan, we conducted a multicenter retrospective study.

Methods:

Questionnaires were sent to collect the data on patients who were first diagnosed with either polycythemia vera, essential thrombocythemia or myelofibrosis and who later were complicated with lymphoid neoplasms defined as malignant lymphoma, multiple myeloma, or chronic lymphocytic leukemia/small cell lymphoma.

Results:

Twenty-four patients with MPNs complicated by lymphoid neoplasms were enrolled (polycythemia vera, n = 8; essential thrombocythemia, n = 14; and primary myelofibrosis, n = 2). Among these, diffuse large B-cell lymphoma (DLBCL) was the most frequently observed (n = 13, 54.1%). Twelve (92.3%) of the patients with DLBCL received conventional chemotherapy. Among these 12 patients, regarding cytoreductive therapy for MPNs, 8 patients stopped treatment, one continued treatment, and two received a reduced dose. Consequently, most patients were able to receive conventional chemotherapy for DLBCL with a slightly higher dose of granulocyte colony-stimulating factor support than usual without worse outcomes. All 3 patients with multiple myeloma received a standard dose of chemotherapy.

Conclusion:

Our data indicate that if aggressive lymphoid neoplasms develop during the course of treatment in patients with MPNs, it is acceptable to prioritize chemotherapy for lymphoma.

KEYWORDS:

• Myeloproliferative neoplasms
• polycythemia vera
• essential thrombocythemia
• myelofibrosis
• lymphoid neoplasms
• chemotherapy
• Japan
• real-world study

Acknowledgement

We thank Tomoko Hashimoto for providing secretarial assistance.

Conflict of interest

YE has received grants or contracts from PharmaEssentia Japan K.K., Meiji Seika Pharma Co. and AbbVie G.K.; honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from PharmaEssentia Japan K.K., Takeda Pharmaceutical Co., Ltd. and Novartis Pharma K.K.; and participated on a advisory board of PharmaEssentia Japan K.K.

TO has received grants or contracts from PharmaEssentia Japan K.K. and Meiji Seika Pharma Co.

YH has received honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Takeda Pharmaceutical Co., Ltd. and Novartis Pharma K.K.

TT has received honoraria for lectures from Otsuka Pharmaceutical Co., LTD., Novartis Pharma K.K., LTD. and Pfizer Japan Inc; and has received research funding from Otsuka Pharmaceutical Co., LTD. and Bristol-Myers Squibb K.K.

KU has received research funding from Astellas Pharma Inc., AbbVie G.K., Bristol-Myers Squibb K.K., Janssen Pharmaceutical K.K., Ono Pharmaceutical Co., LTD., Otsuka Pharmaceutical Co., LTD., Chugai Pharmaceutical Co., Ltd., Apellis Pharmaceuticals, Inc., Yakult Honsha Co., MSD K.K., Amgen-Astellas Biopharma K.K., Alexion Pharmaceuticals, Inc., Incyte Biosciences Japan G.K., Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Sanofi K.K., SynBio Pharmaceuticals Ltd., Celgene K.K., Daiichi Sankyo Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Nippon-Shinyaku Co. Ltd., Novartis Pharma K.K., LTD., Mundipharma K.K. and Takeda Pharmaceutical Co., Ltd.; has served on speakers bureaus for Novartis Pharma K.K., AbbVie G.K., Alexion Pharmaceuticals, Inc., Incyte Biosciences Japan G.K., Ono Pharmaceutical Co., LTD., Kyowa Kirin Co., Ltd., Sanofi K.K., Takeda Pharmaceutical Co., Ltd., Nippon-Shinyaku Co. Ltd., Pfizer Japan Inc. and Bristol-Myers Squibb K.K.; and has served as a consultant and/or member of an advisory board for Astellas Pharma Inc., Amgen-Astellas Biopharma K.K., Alnylam Japan, Alexion Pharmaceuticals, Inc., Eisai Co., Ltd., Otsuka Pharmaceutical Co., LTD. Ohara Pharmaceutical Co.,Ltd., Kyowa Kirin Co., Ltd., Sanofi K.K., Sandoz K.K., SynBio Pharmaceuticals Ltd., Takeda Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd. and Nippon-Shinyaku Co. Ltd.

NT has received research funding from Chugai Pharmaceutical Co., Astellas Pharma Inc., Sumitomo Dainippon Pharma Co., Ltd. and Eisai Co., Ltd.; and has received honoraria directly from an entity from SynBio Pharmaceuticals Ltd., Takeda Pharmaceutical Co., Ltd., Mundipharma K.K. Meiji Seika Pharma Co., Eisai Co., Ltd., Chugai Pharmaceutical Co. and Bristol-Myers Squibb K.K.

NK has received grants from PharmaEssentia Corp., Chugai Pharmaceutical Co., Otsuka Pharmaceutical Co., Takeda Pharmaceutical Co., Sumitomo Pharma Co., Perseus Proteomics Inc., Kyowa Kirin Co., and Meiji Seika Pharma Co., and honoraria from Novartis Japan, Takeda Takeda Pharmaceutical Co., and PharmaEssentia Corp., and has received a salary from PharmaEssentia Japan where he is a board member.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.