Veronika Buxhofer-Ausch1,2, Michael Steurer3, Siegfried Sormann4, Ernst Schloegl5, Wolfgang Schimetta6, Bettina Gisslinger1, Martin Schalling1, Maria Theresa Krauth1, Jürgen Thiele7, Reinhard Ruckser8, 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, Ordensklinikum Linz, Elisabethinen Hospital, 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 Pathology, University of Cologne, Cologne, Germany. 8. Department of Internal Medicine 2, Donauspital, Vienna, Austria.
Abstract
OBJECTIVES: Risk of thrombosis is significantly enhanced by both elevated platelet (PLT) and white blood cell (WBC) counts according to a retrospective analysis of a large anagrelide registry in thrombocythemic MPN patients. We were interested in the impact of elevated WBC counts on thrombosis risk in patients where PLT counts were reduced below the calculated cutoff of 574.5 G/L by treatment with anagrelide. METHODS: Cox regression analysis and Kaplan-Meier plot were applied on all patients in the registry with optimized PLT counts. RESULTS: Using the calculated cutoff of 9.66 G/L for WBC, Cox regression analysis revealed a clear influence of elevated WBC counts on the occurrence of a major thrombotic event (P = .012). A Kaplan-Meier plot revealed a markedly shorter time to a major thrombotic event for patients with WBC counts above the cutoff (P = .001). CONCLUSIONS: These data suggest that additional correction of elevated WBC counts is mandatory in patients with optimally managed PLT counts to reduce thrombotic risk. This study is the first investigation in a prospectively observed large patient cohort which was treated homogenously allowing for evaluation of single parameters for an effect on thrombophilia.
OBJECTIVES: Risk of thrombosis is significantly enhanced by both elevated platelet (PLT) and white blood cell (WBC) counts according to a retrospective analysis of a large anagrelide registry in thrombocythemic MPN patients. We were interested in the impact of elevated WBC counts on thrombosis risk in patients where PLT counts were reduced below the calculated cutoff of 574.5 G/L by treatment with anagrelide. METHODS:Cox regression analysis and Kaplan-Meier plot were applied on all patients in the registry with optimized PLT counts. RESULTS: Using the calculated cutoff of 9.66 G/L for WBC, Cox regression analysis revealed a clear influence of elevated WBC counts on the occurrence of a major thrombotic event (P = .012). A Kaplan-Meier plot revealed a markedly shorter time to a major thrombotic event for patients with WBC counts above the cutoff (P = .001). CONCLUSIONS: These data suggest that additional correction of elevated WBC counts is mandatory in patients with optimally managed PLT counts to reduce thrombotic risk. This study is the first investigation in a prospectively observed large patient cohort which was treated homogenously allowing for evaluation of single parameters for an effect on thrombophilia.
Authors: Radhika Gangaraju; Jihyun Song; Soo Jin Kim; Tsewang Tashi; Brandi N Reeves; Krishna M Sundar; Perumal Thiagarajan; Josef T Prchal Journal: Blood Adv Date: 2020-03-24
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