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Thrombosis and haemorrhage are frequent in patients with essential thrombocythaemia (ET). The 2016 revised International Prognostic Score for Thrombosis in Essential Thrombocythaemia-thrombosis (r-IPSET-t) score stratifies patients into very-low- (VLR), low- (LR), intermediate- (IR) and high-risk (HR) groups. We validated the r-IPSET-t in the biggest population of patients with ET (n = 1381) to date and found it to be a better fit than the earlier IPSET-t score. With an average follow-up of 87.7 months, there were 0.578 thrombotic events/person-year and 0.286 bleeding events/person-year after diagnosis. The 10-year thrombosis-free survival was 88% and 99% for the r-IPSET-t LR and VLR groups (p < 0.001). Cytoreduction was a thrombotic risk factor in younger patients (aged <60 years, hazard ratio 9.49, p = 0.026; aged ≥60 years, hazard ratio 1.04, p = 0.93). In multivariable Cox regression analysis, anti-aggregation after diagnosis was protective for thrombosis (hazard ratio 0.31, p = 0.005) but a risk factor for major bleeding (hazard ratio 10.56, p = 0.021). Of the IPSET-t HR and LR groups, 132/780 and 249/301 were re-classified as LR and VLR respectively (p < 0.001). The European LeukemiaNET (ELN) does not recommend aspirin for VLR patients but in this real-life analysis 83.1% of VLR patients received it. Our results validate the r-IPSET-t score as more predictive for thrombosis than the ELN-recommended IPSET-t and raise concerns about unnecessary cytoreductive and anti-aggregative therapy.

Titel:	Validation of thrombotic risk factors in 1381 patients with essential thrombocythaemia: A multicentre retrospective real-life study.
Autor/in / Beteiligte Person:	Stuckey, R ; Ianotto, JC ; Santoro, M ; Czyż, A ; Perez Encinas, MM ; Gómez-Casares, MT ; Noya Pereira, MS ; de Nałęcz AK ; Gołos, A ; Lewandowski, K ; Szukalski, Ł ; González-Martín, JM ; Wróbel, T ; Sobas, MA
Zeitschrift:	British journal of haematology, Jg. 199 (2022-10-01), Heft 1, S. 86-94
Veröffentlichung:	Oxford : Wiley-Blackwell ; <i>Original Publication</i>: Oxford : Blackwell Scientific Publications, 2022
Medientyp:	academicJournal
ISSN:	1365-2141 (electronic)
DOI:	10.1111/bjh.18387
Schlagwort:	Aspirin therapeutic use Humans Prognosis Retrospective Studies Risk Factors Thrombocythemia, Essential diagnosis Thrombosis diagnosis Thrombosis epidemiology Thrombosis etiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Multicenter Study Language: English [Br J Haematol] 2022 Oct; Vol. 199 (1), pp. 86-94. <i>Date of Electronic Publication: </i>2022 Jul 29. MeSH Terms: Thrombocythemia, Essential* / diagnosis ; Thrombosis* / diagnosis ; Thrombosis* / epidemiology ; Thrombosis* / etiology ; Aspirin / therapeutic use ; Humans ; Prognosis ; Retrospective Studies ; Risk Factors References: Barbui T, Barosi G, Birgegard G, Cervantes F, Finazzi G, Griesshammer M, et al. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. J Clin Oncol. 2011;29(6):761-70. https://doi.org/10.1200/JCO.2010.31.8436. ; Barbui T, Finazzi G, Carobbio A, Thiele J, Passamonti F, Rumi E, et al. Development and validation of an international prognostic score of thrombosis in World Health Organization-essential thrombocythemia (IPSET-thrombosis). Blood. 2012;120(26):5128-33. https://doi.org/10.1182/blood-2012-07-444067. ; Finazzi G, Carobbio A, Thiele J, Passamonti F, Rumi E, Ruggeri M, et al. Incidence and risk factors for bleeding in 1104 patients with essential thrombocythemia or prefibrotic myelofibrosis diagnosed according to the 2008 WHO criteria. Leukemia. 2012;26(4):716-9. https://doi.org/10.1038/leu.2011.258. ; Siller-Matula JM. Hemorrhagic complications associated with aspirin: an underestimated hazard in clinical practice? JAMA. 2012;307(21):2318-20. https://doi.org/10.1001/jama.2012.6152. ; Barbui T, Vannucchi AM, Buxhofer-Ausch V, De Stefano V, Betti S, Rambaldi A, et al. Practice-relevant revision of IPSET-thrombosis based on 1019 patients with WHO-defined essential thrombocythemia. Blood Cancer J. 2015;5(11):e369. https://doi.org/10.1038/bcj.2015.94. ; Alvarez-Larrán A, Pereira A, Guglielmelli P, Hernández-Boluda JC, Arellano-Rodrigo E, Ferrer-Marín F, et al. Antiplatelet therapy versus observation in low-risk essential thrombocythemia with a CALR mutation. Haematologica. 2016;101(8):926-31. https://doi.org/10.3324/haematol.2016.146654. ; Jaffe ES, Harris NL, Stein H, Vardiman JW, editors. World Health Organization classification of tumours, pathology and genetics of tumours of haematopoietic and lymphoid tissues. Lyon, France: IARC Press; 2001. ; Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon, France: IARC Press; 2008. ; Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Revised 4th ed. Lyon, France: IARC Press; 2017. ; Mesa RA, Jamieson C, Bhatia R, Deininger MW, Fletcher CD, Gerds AT, et al. NCCN guidelines insights: myeloproliferative neoplasms, version 2.2018. J Natl Compr Canc Netw. 2017;15(10):1193-207. https://doi.org/10.6004/jnccn.2017.0157. ; Barbui T, Tefferi A, Vannucchi AM, Passamonti F, Silver RT, Hoffman R, et al. Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet. Leukemia. 2018;32(5):1057-69. https://doi.org/10.1038/s41375-018-0077-1. ; Haider M, Gangat N, Lasho T, Abou Hussein AK, Elala YC, Hanson C, et al. Validation of the revised international prognostic score of thrombosis for essential Thrombocythemia (IPSET-thrombosis) in 585 Mayo Clinic patients. Am J Hematol. 2016;91(4):390-4. https://doi.org/10.1002/ajh.24293. ; Santoro M, Accurso V, Mancuso S, Carlisi M, Raso S, Tarantino G, et al. Comparison between thrombotic risk scores in essential thrombocythemia and survival implications. Hematol Oncol. 2019;37(4):434-7. https://doi.org/10.1002/hon.2670. ; Hashimoto Y, Nakamae H, Tanaka T, Omura H, Horiuchi M, Yoshimura T, et al. Validation of previous prognostic models for thrombosis and exploration of modified models in patients with essential thrombocythemia. Eur J Haematol. 2018;101(4):508-13. https://doi.org/10.1111/ejh.13136. ; Choi HS, Hong J, Hwang SM, Lee JH, Ma Y, Kim SA, et al. Evaluation of the need for cytoreduction and its potential carcinogenicity in children and young adults with myeloproliferative neoplasms. Ann Hematol. 2021;100(10):2567-74. https://doi.org/10.1007/s00277-021-04527-7. ; Cortelazzo S, Finazzi G, Ruggeri M, Vestri O, Galli M, Rodeghiero F, et al. Hydroxyurea for patients with essential thrombocythemia and a high risk of thrombosis. N Engl J Med. 1995;332(17):1132-6. https://doi.org/10.1056/NEJM199504273321704. ; Godfrey AL, Campbell PJ, MacLean C, Buck G, Cook J, Temple J, et al. Hydroxycarbamide plus aspirin versus aspirin alone in patients with essential thrombocythemia age 40 to 59 years without high-risk features. J Clin Oncol. 2018;36(34):3361-9. https://doi.org/10.1200/JCO.2018.78.8414. ; Elliott MA, Tefferi A. Thrombosis and haemorrhage in polycythaemia vera and essential thrombocythaemia. Br J Haematol. 2005;128(3):275-90. https://doi.org/10.1111/j.1365-2141.2004.05277.x. ; Campbell PJ, Scott LM, Buck G, Wheatley K, East CL, Marsden JT, et al. Definition of subtypes of essential thrombocythaemia and relation to polycythaemia vera based on JAK2 V617F mutation status: a prospective study. Lancet. 2005;366(9501):1945-53. https://doi.org/10.1016/S0140-6736(05)67785-9. ; Falanga A, Marchetti M, Vignoli A, Balducci D, Russo L, Guerini V, et al. V617F JAK-2 mutation in patients with essential thrombocythemia: relation to platelet, granulocyte, and plasma hemostatic and inflammatory molecules. Exp Hematol. 2007;35(5):702-11. https://doi.org/10.1016/j.exphem.2007.01.053. ; Tefferi A, Vannucchi AM, Barbui T. Essential thrombocythemia treatment algorithm 2018. Blood Cancer J. 2018;8(1):2. https://doi.org/10.1038/s41408-017-0041-8. ; Rotunno G, Mannarelli C, Guglielmelli P, Pacilli A, Pancrazzi A, Pieri L, et al. Impact of calreticulin mutations on clinical and hematological phenotype and outcome in essential thrombocythemia. Blood. 2014;123(10):1552-5. https://doi.org/10.1182/blood-2013-11-538983. ; Rumi E, Pietra D, Ferretti V, Klampfl T, Harutyunyan AS, Milosevic JD, et al. JAK2 or CALR mutation status defines subtypes of essential thrombocythemia with substantially different clinical course and outcomes. Blood. 2014;123(10):1544-51. https://doi.org/10.1182/blood-2013-11-539098. ; Pérez Encinas MM, Sobas M, Gómez-Casares MT, Abuin Blanco A, Noya Pereira MS, Raya JM, et al. The risk of thrombosis in essential thrombocythemia is associated with the type of CALR mutation: a multicentre collaborative study. Eur J Haematol. 2021;106(3):371-9. https://doi.org/10.1111/ejh.13561. ; Morris T, Stables M, Hobbs A, de Souza P, Colville-Nash P, Warner T, et al. Effects of low-dose aspirin on acute inflammatory responses in humans. J Immunol. 2009;183(3):2089-96. https://doi.org/10.4049/jimmunol.0900477. ; Qin Y, Wang X, Zhao C, Wang C, Yang Y. The impact of JAK2V617F mutation on different types of thrombosis risk in patients with essential thrombocythemia: a meta-analysis. Int J Hematol. 2015;102(2):170-80. https://doi.org/10.1007/s12185-015-1808-y. ; Dahabreh IJ, Zoi K, Giannouli S, Zoi C, Loukopoulos D, Voulgarelis M. Is JAK2 V617F mutation more than a diagnostic index? A meta-analysis of clinical outcomes in essential thrombocythemia. Leuk Res. 2009;33(1):67-73. https://doi.org/10.1016/j.leukres.2008.06.006. ; Panova-Noeva M, Marchetti M, Buoro S, Russo L, Leuzzi A, Finazzi G, et al. JAK2V617F mutation and hydroxyurea treatment as determinants of immature platelet parameters in essential thrombocythemia and polycythemia vera patients. Blood. 2011;118(9):2599-601. https://doi.org/10.1182/blood-2011-02-339655. ; Pascale S, Petrucci G, Dragani A, Habib A, Zaccardi F, Pagliaccia F, et al. Aspirin-insensitive thromboxane biosynthesis in essential thrombocythemia is explained by accelerated renewal of the drug target. Blood. 2012;119(15):3595-603. https://doi.org/10.1182/blood-2011-06-359224. ; Arellano-Rodrigo E, Alvarez-Larrán A, Reverter JC, Colomer D, Villamor N, Bellosillo B, et al. Platelet turnover, coagulation factors, and soluble markers of platelet and endothelial activation in essential thrombocythemia: relationship with thrombosis occurrence and JAK2 V617F allele burden. Am J Hematol. 2009;84(2):102-8. https://doi.org/10.1002/ajh.21338. ; Alvarez-Larrán A, Sant'Antonio E, Harrison C, Kiladjian JJ, Griesshammer M, Mesa R, et al. Unmet clinical needs in the management of CALR-mutated essential thrombocythaemia: a consensus-based proposal from the European LeukemiaNet. Lancet Haematol. 2021;8(9):e658-e665. https://doi.org/10.1016/S2352-3026(21)00204-0. Contributed Indexing: Keywords: aspirin; cytoreduction; myeloproliferative neoplasm; prognosis; vascular events Substance Nomenclature: R16CO5Y76E (Aspirin) Entry Date(s): Date Created: 20220730 Date Completed: 20220928 Latest Revision: 20221017 Update Code: 20240513

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Validation of thrombotic risk factors in 1381 patients with essential thrombocythaemia: A multicentre retrospective real-life study.