Real-world patient characteristics and treatment patterns of polycythemia vera in Taiwan between 2016 and 2017: a nationwide cross-sectional study

Tsung-Hsien Tsai; Lennex Hsueh-Lin Yu; Ming-Sun Yu; Shih-Hao Huang; Alex Jia-Hong Lin; Kuan-Der Lee; Min-Chi Chen

doi:10.1177/20406207231179331

Real-world patient characteristics and treatment patterns of polycythemia vera in Taiwan between 2016 and 2017: a nationwide cross-sectional study

Ther Adv Hematol. 2023 Jun 15:14:20406207231179331. doi: 10.1177/20406207231179331. eCollection 2023.

Authors

Tsung-Hsien Tsai¹, Lennex Hsueh-Lin Yu², Ming-Sun Yu^{1

3}, Shih-Hao Huang⁴, Alex Jia-Hong Lin², Kuan-Der Lee^{5

6

7}, Min-Chi Chen^{8

9}

Affiliations

¹ Division of Hematology and Oncology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung.
² Medical Affairs Department, Panco Healthcare Co., Ltd., A PharmaEssentia Company, Taipei.
³ Division of Hematology, Centro Hospitalar Conde de Sao Januario, Macau.
⁴ Department of Public Health and Biostatistics Consulting Center, College of Medicine, Chang Gung University, Taoyuan.
⁵ Cell Therapy and Regenerative Medicine Center and Comprehensive Cancer Center, Taichung Veterans General Hospital, No. 252, Wuxing St, Xinyi District, Taipei 110.
⁶ International Ph.D. Program for Cell Therapy and Regeneration Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei.
⁷ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung.
⁸ Department of Public Health and Biostatistics Consulting Center, College of Medicine, Chang Gung University, No. 259 Wenhua 1st Road, Guishan District, Taoyuan, 333.
⁹ Department of Obstetrics and Gynecology, Chiayi Chang Gung Memorial Hospital, Chiayi.

Abstract

Background: Polycythemia vera (PV) patients often experience constitutional symptoms and are at risk of thromboembolism as well as disease progression to myelofibrosis or acute myeloid leukemia. Not only is PV often overlooked but treatment options are also limited, however.

Objectives: To explore the patient characteristics and treatment pattern of PV patients in Taiwan, and compare with other countries reported in the literature.

Design: This is a nationwide cross-sectional study.

Methods: The National Health Insurance Research Database in Taiwan, which covers 99% of the population, was utilized. Patients were identified during the cross-sectional period between 2016 and 2017, and their retrospective data were retrieved from 2001 to 2017.

Results: A total of 2647 PV patients were identified between 1 January 2016 and 31 December 2017. This study described the demographic information of these patients, including number of patients by risk stratification and by sex, age at diagnosis, age at cross-sectional period, rate of bone marrow aspiration/biopsy at diagnosis, comorbidities, number of postdiagnosis thrombosis, number of disease progression, and death. The mortality rate of PV patients (4.1%) over 60 of age was higher than the general population of the same age group (2.8%). This study also compared the different treatment patterns between sexes and risk groups. Hydroxyurea was deferred to an older age, but conversely was prescribed at higher dose to younger patients. Alarmingly, a high proportion of patients did not receive phlebotomy or hydroxyurea for at least 2 years. Furthermore, discrepancies in prevalence, age at diagnosis, sex ratio, incidence of thrombosis and mortality were also found when compared with data reported in other countries.

Conclusion: The clinical landscape of PV in Taiwan between 2016 and 2017 was examined. Distinctive patterns of phlebotomy and hydroxyurea were identified. Overall, these findings highlight the importance of understanding the patient characteristics and treatment patterns of PV in different regions to better inform clinical practice and improve patient outcomes.

Keywords: cross-sectional study; myeloproliferative neoplasms; nationwide study; polycythemia vera; treatment patterns.