Risk of infections in patients with myeloproliferative neoplasms—a population-based cohort study of 8363 patients

Infections are a common complication in patients with many hematologic malignancies, however, whether patients with myeloproliferative neoplasms (MPN) also are at an increased risk of infections is largely unknown. To assess the risk of serious infections, we performed a large population-based matched cohort study in Sweden including 8 363 MPN patients and 32,405 controls using high-quality registers between the years 1992–2013 with follow-up until 2015. The hazard ratio (HR) of any infection was 2.0 (95% confidence interval 1.9–2.0), of bacterial infections 1.9 (1.8–2.0), and of viral infections 2.1 (1.9–2.3). One of the largest risk increases was that of sepsis, HR 2.6 (2.4–2.9). The HR of any infection was highest in primary myelofibrosis 3.7 (3.2–4.1), and significantly elevated in all MPN subtypes; 1.7 (1.6–1.8) in polycythemia vera and 1.7 (1.5–1.8) in essential thrombocythemia. There was no significant difference in risk of infections between untreated patients and patients treated with hydroxyurea or interferon-α during the years 2006–2013. These novel findings of an overall increased risk of infections in MPN patients, irrespective of common cytoreductive treatments, suggest the increased risk of infection is inherent to the MPN.