Veronika Buxhofer-Ausch1,2, Michael Steurer3, Siegfried Sormann4, Ernst Schloegl5, Wolfgang Schimetta6, Bettina Gisslinger1, Reinhard Ruckser7, Günther Gastl3, Heinz Gisslinger1. 1. Division of Hematology and Blood Coagulation, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria. 2. Department of Internal Medicine I, Elisabethinen Hospital Linz, Linz, Austria. 3. Division of Hematology and Oncology, Innsbruck Medical University, Innsbruck, Austria. 4. Department of Hematology, Medical University of Graz, Graz, Austria. 5. Department of Internal Medicine 3, Hanusch Hospital, Vienna, Austria. 6. Department of Applied Systems Research and Statistics, Johannes Kepler University, Linz, Austria. 7. Department of Internal Medicine 2, Donauspital, Vienna, Austria.
Abstract
OBJECTIVES: Although guidelines recommend normalization of platelet counts as an appropriate endpoint for treatment in high-risk essential thrombocythemia (ET), retrospective studies could not prove a correlation of diagnostic platelet counts with an increased thrombotic rate. There is, however, an increasing evidence that leukocytosis is an important risk factor for arterial thrombosis in myeloproliferative neoplasms. METHODS: This study considers the Austrian cohort of a European registry regarding the platelet-lowering therapeutic anagrelide. Influence of platelet and white blood cell (WBC) counts on thrombotic risk was assessed. RESULTS: Using the calculated cutoffs of 574.5 G/L for platelets and 8.48 G/L for WBC counts, respectively, the Cox regression analysis revealed a clear influence of elevated platelets (P = 0.008) and WBC counts (P = 0.011) on the occurrence of major thrombotic events. The time to a major thrombotic event was shortest (P < 0.001) and the frequency related to 100 patient-years was highest (P = <0.001) when both platelet and WBC counts ranged above the calculated cutoffs. CONCLUSION: 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.
OBJECTIVES: Although guidelines recommend normalization of platelet counts as an appropriate endpoint for treatment in high-risk essential thrombocythemia (ET), retrospective studies could not prove a correlation of diagnostic platelet counts with an increased thrombotic rate. There is, however, an increasing evidence that leukocytosis is an important risk factor for arterial thrombosis in myeloproliferative neoplasms. METHODS: This study considers the Austrian cohort of a European registry regarding the platelet-lowering therapeutic anagrelide. Influence of platelet and white blood cell (WBC) counts on thrombotic risk was assessed. RESULTS: Using the calculated cutoffs of 574.5 G/L for platelets and 8.48 G/L for WBC counts, respectively, the Cox regression analysis revealed a clear influence of elevated platelets (P = 0.008) and WBC counts (P = 0.011) on the occurrence of major thrombotic events. The time to a major thrombotic event was shortest (P < 0.001) and the frequency related to 100 patient-years was highest (P = <0.001) when both platelet and WBC counts ranged above the calculated cutoffs. CONCLUSION: 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.
Authors: Veronika Buxhofer-Ausch; Sonja Heibl; Thamer Sliwa; Christine Beham-Schmid; Dominik Wolf; Klaus Geissler; Maria Theresa Krauth; Peter Krippl; Andreas Petzer; Albert Wölfler; Thomas Melchardt; Heinz Gisslinger Journal: Wien Klin Wochenschr Date: 2020-11-19 Impact factor: 1.704
Authors: Gunnar Birgegård; Carlos Besses; Martin Griesshammer; Luigi Gugliotta; Claire N Harrison; Mohamed Hamdani; Jingyang Wu; Heinrich Achenbach; Jean-Jacques Kiladjian Journal: Haematologica Date: 2017-10-27 Impact factor: 9.941