Thrombosis and survival in essential thrombocythemia: A regional study of 1,144 patients

Montanaro, Marco; Latagliata, Roberto; Cedrone, Michele; Spadea, Antonio; Rago, Angela; Giandomenico, Jonny Di; Spirito, Francesca; Porrini, Raffaele; Muro, Marianna De; Leonetti, Sabrina Crescenzi; Villivà, Nicoletta; Gregoris, Cinzia De; Breccia, Massimo; Madon, E; Santoro, Cristina; Cimino, Giuseppe; Majolino, Ignazio; Mazzucconi, Maria Gabriella; Andriani, A

doi:10.1002/ajh.23685

Cited by 38 publications

(25 citation statements)

References 16 publications

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“…1,7,8,10,16 Interestingly, age ≥ 60 years in our cohort of patients was not a significant risk factor for thrombosis. The lack of correlation between older age and thrombosis was also seen in other recent studies such as those of Lekovic et al 1 and Montanaro et al 20 The presence of JAK2 mutation was not significantly associated with thrombosis in our study, contrary to information well-established in the literature. 14,16,[20][21][22] We believe that our small sample size may explain why we found no correlation between thrombosis risk and the presence of JAK2 mutation.…”

Section: Discussioncontrasting

confidence: 72%

Application of prognostic score IPSET-thrombosis in patients with essential thrombocythemia of a Brazilian public service

Navarro

Trufelli

Bonito

et al. 2016

Rev. Assoc. Med. Bras.

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Section: Discussioncontrasting

confidence: 72%

Application of prognostic score IPSET-thrombosis in patients with essential thrombocythemia of a Brazilian public service

Navarro

Trufelli

Bonito

et al. 2016

Rev. Assoc. Med. Bras.

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“…Recently, additional risk factors for thrombosis have been evaluated, including influence of JAK2 mutation, leukocytosis, thrombocytosis and cardiovascular (CV) risk factors but with conflicting results [8][9][10][11]. Also, an older age lost the prognostic value in multivariate analysis [12].…”

Section: Introductionmentioning

confidence: 99%

The importance of cardiovascular risk factors for thrombosis prediction in patients with essential thrombocythemia

et al. 2014

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The current widely accepted stratification defined by age and previous thrombosis in patients with essential thrombocythemia (ET) probably deserves deeper analysis. The aim of our study was to identify additional factors at the time of diagnosis, which have an impact on the thrombosis prediction. We conducted a study of 244 consecutive ET patients with median follow-up of 83 months. We analyzed the influence of age, gender, laboratory parameters, history of previous thrombosis, spleen size, JAK2 mutation as well as cardiovascular (CV) risk factors including arterial hypertension, diabetes, active tobacco use and hyperlipidemia in the terms of thrombosis. The most important predictors of thrombosis in multivariate Cox regression model were the presence of CV risk factors (p=0.004) and previous thrombosis (p=0.038). Accordingly, we assigned risk scores based on multivariable analysis-derived hazard ratios (HR) to the presence of 1 CV risk factor (HR=3.5; 1 point), >1 CV risk factors (HR=8.3; 2 points) and previous thrombosis (HR=2.0; 1 point). A final three-tiered prognostic model for thrombosis prediction was developed as low (score 0), intermediate (score 1 or 2) and high risk (score 3) (p<0.001). The hazard of thrombosis was 3.8% in low-risk group, 16.7% in the intermediate-risk group and 60% in the high-risk group (p<0.001). Patients with thrombotic complications during the follow-up had a significantly shorter survival (p=0.018). The new score based on CV risk factors and previous thrombotic events allows a better patient selection within prognostic-risk groups and improved identification of the high-risk patients for thrombosis.

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“…Currently, advanced age (60 years) and history of previous thrombosis are the two major risk factors that identify high-risk patients requiring a platelet-lowering chemotherapy [5][6][7]. To this regard, older thrombotic events (>24 months before ET diagnosis) seem to have a more prominent prognostic role compared to thrombosis occurring closer to diagnosis [8]. Many other clinical, laboratory, and biological features, such as cardiovascular risk factors (CVRF), leucocytosis, JAK2V617F mutation and allele burden have been proposed as additional risk factors for thrombosis, with conflicting results [8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Spleen enlargement is a risk factor for thrombosis in essential thrombocythemia: Evaluation on 1,297 patients

Andriani

Latagliata²,

Anaclerico

et al. 2016

American J Hematol

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Spleen enlargement, present in 10–20% of Essential Thrombocythemia (ET) patients at diagnosis, is a feature clinically easy to assess, confirmable by echography with a very low chance of misinterpretation. Nonetheless, the clinical and prognostic role of splenomegaly has been seldom evaluated. From 1979 to 2013, 1297 ET patients retrospectively collected in the database of the Lazio Cooperative Group and Bologna University Hospital were evaluable for spleen enlargement at diagnosis and included in the analysis. On the whole, spleen was enlarged in 172/1297 (13.0%) patients; in most cases (94.8%) splenomegaly was mild (≤5 cm). Patients with splenomegaly were younger, predominantly male, presented higher platelet count and JAK2V617F allele burden and had a lower incidence of concomitant cardiovascular risk factors. At least one thrombotic event during follow‐up occurred in 97/1,125 (8.6%) patients without spleen enlargement compared to 27/172 (15.7%) patients with spleen enlargement (P = 0.003). Despite comparable use of cytoreductive/antiplatelet therapies in the two groups, the cumulative risk of thrombosis at 5 years was significantly higher in patients with baseline splenomegaly (9.8% versus 4.4% in patients without splenomegaly, P = 0.012). In multivariate analysis exploring risk factors for thrombosis, splenomegaly retained its negative prognostic role, together with previous thrombosis, leucocyte count and male gender. Baseline splenomegaly seems to be an independent additional risk factor for thrombosis in nonstrictly WHO‐defined ET patients. This data could be useful in the real‐life clinical management of these patients. Am. J. Hematol. 91:318–321, 2016. © 2016 Wiley Periodicals, Inc.

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Thrombosis and survival in essential thrombocythemia: A regional study of 1,144 patients

Cited by 38 publications

References 16 publications

Application of prognostic score IPSET-thrombosis in patients with essential thrombocythemia of a Brazilian public service

Application of prognostic score IPSET-thrombosis in patients with essential thrombocythemia of a Brazilian public service

The importance of cardiovascular risk factors for thrombosis prediction in patients with essential thrombocythemia

Spleen enlargement is a risk factor for thrombosis in essential thrombocythemia: Evaluation on 1,297 patients

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