Influence of platelet and white blood cell counts on major thrombosis – analysis from a patient registry in essential thrombocythemia

Buxhofer‐Ausch, Veronika; Steurer, Michael; Sormann, Siegfried; Schloegl, Ernst; Schimetta, Wolfgang; Gisslinger, Bettina; Ruckser, Reinhard; Gastl, Günther; Gisslinger, Heinz

doi:10.1111/ejh.12759

Cited by 36 publications

(34 citation statements)

References 32 publications

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“…Eight percent of the ET patients experienced at least one vascular complication during the follow‐up time corresponding to 1.4 thromboembolic and 0.6 hemorrhagic events per 100 patient‐years, respectively. The incidence of thromboembolic events is identical to the report from the Austrian MPN registry …”

Section: Discussionsupporting

confidence: 90%

“…Previous reports in MPNs have confirmed a high incidence of vascular complications . The underlying factors predisposing for vascular complications are often multifactorial involving disease‐specific factors, treatment‐related protective factors and comorbid classical vascular risk factors .…”

Section: Introductionmentioning

confidence: 94%

“…17 Previous reports in MPNs have confirmed a high incidence of vascular complications. 4,[18][19][20] The underlying factors predisposing for vascular complications are often multifactorial involving disease-specific factors, treatment-related protective factors and comorbid classical vascular risk factors. 21 Importantly, one smaller study from the Hamilton region in Canada has demonstrated an inferior prognosis for patients not treated in accordance with guidelines.…”

mentioning

confidence: 99%

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Highly reduced survival in essential thrombocythemia and polycythemia vera patients with vascular complications during follow‐up

Ahlstrand

Samuelsson

Lindgren

et al. 2020

European J of Haematology

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Objective To explore the relative importance of risk factors, treatments, and blood counts for the occurrence of vascular complications and their impact on life expectancy in essential thrombocythemia (ET) and polycythemia vera (PV). Methods Nested case‐control study within the Swedish MPN registry. From a cohort of 922 ET patients and 763 PV patients, 71 ET and 81 PV cases with vascular complications were compared with matched controls. Results Incidence of vascular complications was 2.0 and 3.4 events per 100 patient‐years in ET and PV, respectively. At diagnosis, no significant risk factor differences were observed between cases and controls in neither of the diseases. At the time of vascular event, ET complication cases did not differ significantly from controls but in PV, cases had significantly higher WBCs and were to a lesser extent treated with anti‐thrombotic and cytoreductive therapy. Life expectancy was significantly decreased in both ET and PV cases compared with controls. Conclusions The risk of vascular complications is high in both ET and PV, and these complications have a considerable impact on life expectancy. The protective effect of anti‐thrombotic and cytoreductive therapy for vascular complications in PV underscores the importance of avoiding undertreatment.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 94%

mentioning

confidence: 99%

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Highly reduced survival in essential thrombocythemia and polycythemia vera patients with vascular complications during follow‐up

Ahlstrand

Samuelsson

Lindgren

et al. 2020

European J of Haematology

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“…The increased risk of thrombosis in these patients may partly be explained by the increased platelet count, although no causal relation has been established . Our group previously demonstrated a positive association between platelet count and platelet aggregation in individuals with platelet counts within the reference interval .…”

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confidence: 99%

Platelet characteristics in patients with essential thrombocytosis

Pedersen

Larsen

Grove

et al. 2018

Cytometry Part B Clinical

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“…Notably, the trial was designed to test non‐inferiority of the two formulations rather than superiority. The primary endpoint of the trial, platelet counts during the maintenance period, was chosen because high platelet counts are associated with a higher risk to develop thrombosis in ET patients (Piccin et al , ; Buxhofer‐Ausch et al , ; Schwarz et al , ).…”

Section: Discussionmentioning

confidence: 99%

A phase III randomized, multicentre, double blind, active controlled trial to compare the efficacy and safety of two different anagrelide formulations in patients with essential thrombocythaemia – the TEAM‐ET 2·0 trial

et al. 2019

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Summary Anagrelide is an established treatment option for essential thrombocythaemia ( ET ). A prolonged release formulation was developed with the aim of reducing dosing frequency and improving tolerability, without diminishing efficacy. This multicentre, randomized, double blind, active‐controlled, non‐inferiority trial investigated the efficacy, safety and tolerability of anagrelide prolonged release (A‐ PR ) over a reference product in high‐risk ET patients, either anagrelide‐naïve or ‐experienced. In a 6 to 12‐week titration period the individual dose for the consecutive 4‐week maintenance period was identified. The primary endpoint was the mean platelet count during the maintenance period (3 consecutive measurements, day 0, 14, 28). Of 112 included patients 106 were randomized. The mean screening platelet counts were 822 × 10 9 /l (95% confidence interval ( CI ) 707–936 × 10 9 /l) and 797 × 10 9 /l (95% CI 708–883 × 10 9 /l) for A‐ PR and the reference product, respectively. Both treatments effectively reduced platelet counts, to mean 281 × 10 9 /l for A‐ PR (95% CI 254–311) and 305 × 10 9 /l (95% CI 276–337) for the reference product ( P < 0·0001, for non‐inferiority). Safety and tolerability were comparable between both drugs. The novel prolonged‐release formulation was equally effective and well tolerated compared to the reference product. A‐ PR provides a more convenient dosing schedule and will offer an alternative to licensed immediate‐release anagrelide formulations.

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Influence of platelet and white blood cell counts on major thrombosis – analysis from a patient registry in essential thrombocythemia

Abstract: Our data add evidence to the impact of platelet and WBC counts on thrombosis in ET. We suspect a particular interaction between platelets and WBC which might be based on a biological interplay depending on particular cell counts.

Cited by 36 publications

References 32 publications

Highly reduced survival in essential thrombocythemia and polycythemia vera patients with vascular complications during follow‐up

Highly reduced survival in essential thrombocythemia and polycythemia vera patients with vascular complications during follow‐up

Platelet characteristics in patients with essential thrombocytosis

A phase III randomized, multicentre, double blind, active controlled trial to compare the efficacy and safety of two different anagrelide formulations in patients with essential thrombocythaemia – the TEAM‐ET 2·0 trial

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