Impact of leukocytosis on thrombotic risk and survival in 532 patients with essential thrombocythemia: a retrospective study

Palandri, Francesca; Polverelli, Nicola; Catani, Lucia; Ottaviani, Emanuela; Baccarani, Michele; Vianelli, Nicola

doi:10.1007/s00277-010-1154-3

Cited by 61 publications

(39 citation statements)

References 20 publications

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“…Thus, they have been widely examined, aiming to prevent them with the identification of prognostic factors at disease onset: up to now, there is a worldwide agreement on the predictive role of older age and previous thromboses, and these two factors are generally used to define the thrombotic risk of each patient at diagnosis [7][8][9][10][11][12][13]. On the other hand, as shown in Table VII, there were conflicting results when other factors potentially affecting the thrombotic risk were examined.…”

Section: Discussionmentioning

confidence: 99%

“…To date, many clinical studies focused on factors predicting thrombotic complications and survival [7][8][9][10][11][12][13]; whereas a general agreement exists on the prognostic role of age superior to 60 years and previous thrombotic events, some other clinical (white blood cell [WBC] and PLT counts, cardiovascular [CV] risk factors) and biological factors (JAK2 V617F mutation, allele burden) have been evaluated with conflicting results.…”

Section: Introductionmentioning

confidence: 99%

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

Montanaro

Latagliata

Cedrone³

et al. 2014

American J Hematol

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To identify prognostic factors affecting thrombosis-free survival (TFS) and overall survival (OS), we report the experience of a Regional cooperative group in a real-life cohort of 1,144 patients with essential thrombocythemia (ET) diagnosed from January 1979 to December 2010. There were 107 thrombotic events (9.4%) during follow-up [60 (5.3%) arterial and 47 (4.1%) venous thromboses]. At univariate analysis, risk factors for a shorter TFS were: age >60 years (P < 0.0054, 95% CI 1.18-2.6), previous thrombosis (P < 0.0001, 95% CI 1.58-4.52) and the presence of at least one cardiovascular risk factor (P 5 0.036, 95% CI 1.15-3.13). Patients with a previous thrombosis occurred 24 months before ET diagnosis had a shorter TFS compared to patients with a previous thrombosis occurred <24 months (P 5 0.0029, 95% CI 1.5-6.1); furthermore, patients with previous thrombosis occurred <24 months did not show a shorter TFS compared with patients without previous thrombosis (P 5 0.303, 95% CI 0.64-3.21). At multivariate analysis for TFS, only the occurrence of a previous thrombosis maintained its prognostic impact (P 5 0.0004, 95% CI 1.48-3.79, RR 2.36). The 10-year OS was 89.9% (95% CI 87.3-92.5): at multivariate analysis for OS, age >60 years (P < 0.0001), anemia (P < 0.0001), male gender (P 5 0.0019), previous thromboses (P 5 0.0344), and white blood cell >15 3 10 9 /l (P 5 0.0370) were independent risk factors. Previous thrombotic events in ET patients are crucial for TFS but their importance seems related not to the occurrence per se but mainly to the interval between the event and the diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Montanaro

Latagliata

Cedrone³

et al. 2014

American J Hematol

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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].…”

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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“…8,9 Concerning prognostic models powered to predict survival, advanced age, leukocytosis, and anemia have been incorporated as risk factors. [10][11][12] In this study, we developed a prognostic model to predict survival in WHO-defined ET, named International Prognostic Score for Essential Thrombocythemia (IPSET), starting from 891 patients diagnosed strictly according to WHO criteria.…”

Section: Introductionmentioning

confidence: 99%

A prognostic model to predict survival in 867 World Health Organization–defined essential thrombocythemia at diagnosis: a study by the International Working Group on Myelofibrosis Research and Treatment

Passamonti

Thiele

Girodon

et al. 2012

Blood

225

185

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Impact of leukocytosis on thrombotic risk and survival in 532 patients with essential thrombocythemia: a retrospective study

Cited by 61 publications

References 20 publications

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

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

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

A prognostic model to predict survival in 867 World Health Organization–defined essential thrombocythemia at diagnosis: a study by the International Working Group on Myelofibrosis Research and Treatment

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