BACKGROUND: Advanced age and a history of thrombosis were well-established risk factors for thrombosis in essential thrombocythemia (ET) and polycythemia vera (PV); cytoreductive therapy was indicated in their presence. Recent studies have suggested leukocytosis as an additional risk factor; however, such an association would be treatment-relevant in the context of low-risk disease. METHODS: In this retrospective study, a Cox proportional hazards model was used to determine the impact of various clinical and laboratory variables, including leukocytosis, on thrombosis-free survival (TFS). Arterial-specific or venous-specific TFS curves for different leukocyte count-defined risk groups were constructed by the Kaplan-Meier method and compared using the log-rank test. RESULTS: A total of 407 low-risk patients (254 with ET and 153 with PV) were considered. After a respective median follow-up of 104 months and 130 months, respectively, 47 (19%) patients with ET and 41 (27%) with PV experienced a total of 55 (41 arterial and 14 venous) and 46 (22 arterial and 24 venous) thrombotic events, respectively. Leukocytosis at the time of diagnosis, defined by a cutoff level of either 15 or 9.4x10(9)/L, did not appear to be predictive of either arterial or venous thrombosis during follow-up; similar results were obtained when analysis was restricted to patients with platelet counts of <1000x10(9)/L. Instead, advanced age was found to be significantly associated with arterial thrombosis in patients with PV and higher hemoglobin level with venous thrombosis in patients with ET. CONCLUSIONS: In the current retrospective study, leukocytosis at diagnosis did not appear to influence the risk of thrombosis in either ET or PV. However, a prospective study is required before leukocytosis is taken into account during treatment decisions in these disorders. Copyright (c) 2009 American Cancer Society.
BACKGROUND: Advanced age and a history of thrombosis were well-established risk factors for thrombosis in essential thrombocythemia (ET) and polycythemia vera (PV); cytoreductive therapy was indicated in their presence. Recent studies have suggested leukocytosis as an additional risk factor; however, such an association would be treatment-relevant in the context of low-risk disease. METHODS: In this retrospective study, a Cox proportional hazards model was used to determine the impact of various clinical and laboratory variables, including leukocytosis, on thrombosis-free survival (TFS). Arterial-specific or venous-specific TFS curves for different leukocyte count-defined risk groups were constructed by the Kaplan-Meier method and compared using the log-rank test. RESULTS: A total of 407 low-risk patients (254 with ET and 153 with PV) were considered. After a respective median follow-up of 104 months and 130 months, respectively, 47 (19%) patients with ET and 41 (27%) with PV experienced a total of 55 (41 arterial and 14 venous) and 46 (22 arterial and 24 venous) thrombotic events, respectively. Leukocytosis at the time of diagnosis, defined by a cutoff level of either 15 or 9.4x10(9)/L, did not appear to be predictive of either arterial or venous thrombosis during follow-up; similar results were obtained when analysis was restricted to patients with platelet counts of <1000x10(9)/L. Instead, advanced age was found to be significantly associated with arterial thrombosis in patients with PV and higher hemoglobin level with venous thrombosis in patients with ET. CONCLUSIONS: In the current retrospective study, leukocytosis at diagnosis did not appear to influence the risk of thrombosis in either ET or PV. However, a prospective study is required before leukocytosis is taken into account during treatment decisions in these disorders. Copyright (c) 2009 American Cancer Society.
Authors: Andrea Piccin; Michael Steurer; Manfred Mitterer; Elisabeth Maria Blöchl; Luigi Marcheselli; Irene Pusceddu; Alessandra Marabese; Irene Bertozzi; Daisy Corvetta; Maria Luigia Randi; Elena Elli; Enrico Maria Pogliani; Dino Veneri; Omar Perbellini; Mauro Krampera; Enrica Pacquola; Michele Gottardi; Mario Tiribelli; Anna Guella; Barbara Innella; Paolo Vivaldi; Ercole De Biasi; Rosaria Sancetta; Roberta Rocconi; Renato Bassan; Filippo Gherlinzoni; Giovanni Pizzolo; Günther Gastl; Sergio Cortelazzo Journal: Intern Emerg Med Date: 2015-01-14 Impact factor: 3.397
Authors: Peter J Campbell; Cathy MacLean; Philip A Beer; Georgina Buck; Keith Wheatley; Jean-Jacques Kiladjian; Cecily Forsyth; Claire N Harrison; Anthony R Green Journal: Blood Date: 2012-06-18 Impact factor: 22.113
Authors: Novella Pugliese; Claudia Giordano; Davide Nappi; Luigiana Luciano; Claudio Cerchione; Mario Annunziata; Beniamino Casale; Elena Crisà; Maria Rosaria Villa; Luca Pezzullo; Maria Iovine; Marco Picardi; Francesco Grimaldi; Fabrizio Pane; Vincenzo Martinelli Journal: Cancer Med Date: 2019-04-17 Impact factor: 4.452