Application of IPSET-thrombosis in 1366 Patients Prospectively Followed From the Spanish Registry of Essential Thrombocythemia

Abstract

The International Prognostic Score of thrombosis in Essential Thrombocythemia (IPSET-thrombosis) and its revised version have been proposed to guide thrombosis prevention strategies. We evaluated both classifications to prognosticate thrombosis in 1366 contemporary essential thrombocythemia (ET) patients prospectively followed from the Spanish Registry of ET. The cumulative incidence of thrombosis at 10 years, taking death as a competing risk, was 11.4%. The risk of thrombosis was significantly higher in the high-risk IPSET-thrombosis and high-risk revised IPSET-thrombosis, but no differences were observed among the lower risk categories. Patients allocated in high-risk IPSET-thrombosis (subdistribution hazard ratios [SHR], 3.7 [95% confidence interval, CI, 1.6-8.7]) and high-risk revised IPSET-thrombosis (SHR, 3.2 [95% CI, 1.4-7.45]) showed an increased risk of arterial thrombosis, whereas both scoring systems failed to predict venous thrombosis. The incidence rate of thrombosis in intermediate risk revised IPSET-thrombosis (aged >60 years, JAK2-negative, and no history of thrombosis) was very low regardless of the treatment administered (0.9% and 0% per year with and without cytoreduction, respectively). Dynamic application of the revised IPSET-thrombosis showed a low rate of thrombosis when patients without history of prior thrombosis switched to a higher risk category after reaching 60 years of age. In conclusion, IPSET-thrombosis scores are useful for identifying patients at high risk of arterial thrombosis, whereas they fail to predict venous thrombosis. Controlled studies are needed to determine the appropriate treatment of ET patients assigned to the non-high-risk categories.

Case report: Peri-procedural hydroxyurea helps minimize bleeding in patients with Essential Thrombocythemia associated with acquired von Willebrand syndrome

“…Since the primary objective of ET management is to prevent thromboembolic complications, the risk of venous thromboembolism must be assessed in each ET patient. The International prognostic score of thrombosis in Essential Thrombocythemia (IPSET-Thrombosis) model provides objective estimates of the probability of thrombotic events in patients with newly diagnosed ET ( 21 ). Scores of ≥3 points put patients into the high-risk category with an annual thrombosis risk of 3.56% ( 4 ).…”

Essential thrombocythemia: 2024 update on diagnosis, risk stratification, and management

“…65 The thrombosis risk rates in intermediateand high-risk disease were 1.44%-1.64% and 2.36%-4.17% patients/ year, respectively. 65 The revised IPSET-thrombosis has been validated by multiple subsequent studies 67,68 while the original IPSETthrombosis score performed better in prefibrotic MF. 69 Separate analysis of arterial and venous thrombosis was performed on the IPSET database of 891 patients with WHO-defined ET; 70 both arterial and venous thrombotic events, in the Mayo cohort, while a similar protective role was apparent for cytoreductive therapy, in the Florence cohort.…”

The clinical significance of TAT, PIC, TM, and t-PAIC in vascular events of BCR/ABL-negative myeloproliferative neoplasms

“…IPSET-thrombosis scores are useful for identifying patients at high risk of arterial thrombosis, whereas they fail to predict venous thrombosis [ 15 ]. The revised IPSET-thrombosis identified four risk categories based on three adverse variables (thrombosis history, age > 60 years and JAK2V617F).…”