Guido Finazzi1. 1. Division of Hematology, Ospedali Riuniti, Largo Barozzi 1, 24128 Bergamo, Italy. gfinazzi@ospedaliriuniti.bergano.it
Abstract
BACKGROUND: - The clinical course of polycythemia vera (PV) is often complicated by arterial and venous thrombosis. Current information on these vascular complications derives from very few prospective clinical trials and several retrospective studies. The purpose of this analysis is to report the incidence, clinical features and risk factors for thrombosis in a large number of patients prospectively followed in a multicountry European study. METHODS: - The European collaboration on low-dose aspirin in polycythemia vera (ECLAP) study is a multicenter project aimed at describing the natural history of PV. Overall, 1630 PV patients (57% males, median age at recruitment 65 years) were enrolled in the study. Five hundred and eighteen (32%) of these patients are entered into a parallel, double-blind, placebo-controlled, randomized clinical trial aimed at assessing the efficacy and safety of low-dose aspirin. The remaining 1112 (68%) are entered into an ongoing, observational, prospective, cohort study. The mean follow-up duration was 2.7 years (range 0-5.3). FINDINGS: - The cumulative incidence rate of cardiovascular events (i.e. cardiovascular death and non-fatal thrombotic events) was 5.5 events/100 persons per year. Thrombosis was the main cause of death. Age greater than 65 years and positive history of thrombosis were the two most important predictors of cardiovascular events. Smoking, hypertension and congestive heart failure were other significant risk factors for thrombosis. Platelet counts and myelosuppressive drugs were not associated with the risk of cardiovascular events. Antiplatelet therapy was the only variable associated with a lower risk of thrombosis. CONCLUSION: - Cardiovascular events remain a major cause of mortality and morbidity in PV but the thrombotic risk seems to be more related to the patients' characteristics (age, previous thrombosis, cardiovascular risk factors) than to the disease itself. Thus, control of red cell mass and antithrombotic therapy appear to be effective treatments in limiting the risk of thrombosis.
RCT Entities:
BACKGROUND: - The clinical course of polycythemia vera (PV) is often complicated by arterial and venous thrombosis. Current information on these vascular complications derives from very few prospective clinical trials and several retrospective studies. The purpose of this analysis is to report the incidence, clinical features and risk factors for thrombosis in a large number of patients prospectively followed in a multicountry European study. METHODS: - The European collaboration on low-dose aspirin in polycythemia vera (ECLAP) study is a multicenter project aimed at describing the natural history of PV. Overall, 1630 PV patients (57% males, median age at recruitment 65 years) were enrolled in the study. Five hundred and eighteen (32%) of these patients are entered into a parallel, double-blind, placebo-controlled, randomized clinical trial aimed at assessing the efficacy and safety of low-dose aspirin. The remaining 1112 (68%) are entered into an ongoing, observational, prospective, cohort study. The mean follow-up duration was 2.7 years (range 0-5.3). FINDINGS: - The cumulative incidence rate of cardiovascular events (i.e. cardiovascular death and non-fatal thrombotic events) was 5.5 events/100 persons per year. Thrombosis was the main cause of death. Age greater than 65 years and positive history of thrombosis were the two most important predictors of cardiovascular events. Smoking, hypertension and congestive heart failure were other significant risk factors for thrombosis. Platelet counts and myelosuppressive drugs were not associated with the risk of cardiovascular events. Antiplatelet therapy was the only variable associated with a lower risk of thrombosis. CONCLUSION: - Cardiovascular events remain a major cause of mortality and morbidity in PV but the thrombotic risk seems to be more related to the patients' characteristics (age, previous thrombosis, cardiovascular risk factors) than to the disease itself. Thus, control of red cell mass and antithrombotic therapy appear to be effective treatments in limiting the risk of thrombosis.
Authors: Nikolai A Podoltsev; Mengxin Zhu; Amer M Zeidan; Rong Wang; Xiaoyi Wang; Amy J Davidoff; Scott F Huntington; Smith Giri; Steven D Gore; Xiaomei Ma Journal: Blood Adv Date: 2018-10-23
Authors: Yee Yee Yap; Kian Boon Law; Jameela Sathar; Ngee Siang Lau; Ai Sim Goh; Teng Keat Chew; Soo Min Lim; Padmini Menon; Yong Khee Guan; Azlan Bin Husin; Lily Lee Lee Wong; Lee Ping Chew; Sinari Salleh; Kim Yen Goh; Kin Wah Leong; Sen Mui Tan; Tee Chuan Ong; Su Hong Lim; See Guan Toh; Xavier Sim Yoon Han; Syed Carlo Edmund; Jenq Tzong Tan; Kian Meng Chang Journal: Exp Hematol Oncol Date: 2018-12-17
Authors: Inger Lise Gade; Søren Kold; Marianne T Severinsen; Kristian H Kragholm; Christian Torp-Pedersen; Søren R Kristensen; Signe J Riddersholm Journal: Res Pract Thromb Haemost Date: 2020-11-30