Application of IPSET-thrombosis in 1366 Patients Prospectively Followed From the Spanish Registry of Essential Thrombocythemia.

Autor: Alvarez-Larrán A; Hospital Clínic Barcelona, Spain., Cuevas B; Hospital Universitario de Burgos, Spain., Velez P; Hospital de Mar, Barcelona, Spain., Noya S; Complexo Hospitalario Universitario de A Coruña, Spain., Caballero-Navarro G; Hospital Miguel Servet, Zaragoza, Spain., Ferrer-Marín F; Hospital Morales Messeguer, CIBERER, UCAM, IMIB, Murcia, Spain., Carbonell S; Hospital Clínic Barcelona, Spain., Pérez-Encinas M; Hospital Clínico Universitario de Santiago de Compostela, Spain., Gómez-Casares MT; Hospital Doctor Negrín, Las Palmas de Gran Canaria, Spain., Pérez-López R; Hospital Virgen de la Arrixaca, Murcia, Spain., Magro E; Hospital Príncipe de Asturias, Alcalá de Henares, Spain., Moretó A; Hospital de Cruces, Barakaldo, Spain., Pastor-Galán I; Hospital Clínico Universitario, Valencia, Spain., Angona A; Hospital Doctor Josep Trueta, Girona, Spain., Mata-Vázquez MI; Hospital Costa del Sol, Marbella, Spain., Guerrero-Fernández L; Complejo Asistencial de Palencia, Spain., Guerra JM; Hospital Son Llatzer, Palma de Mallorca, Spain., Carreño-Tarragona G; Hospital Universitario 12 de octubre, Madrid, Spain., Fox L; Hospital Universitario Vall d'Hebron, Barcelona, Spain., Murillo I; Hospital General San Jorge, Huesca, Spain., García-Gutiérrez V; Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain., Mora E; Hospital Universitario y Politécnico La Fe, Valencia, Spain., Stuckey R; Hospital Virgen de la Arrixaca, Murcia, Spain., Arellano-Rodrigo E; Hospital Clínic Barcelona, Spain., Hernández-Boluda JC; Hospital Clínico Universitario, Valencia, Spain., Pereira A; Hospital Clínic Barcelona, Spain.
Jazyk: angličtina
Zdroj: HemaSphere [Hemasphere] 2023 Jul 18; Vol. 7 (8), pp. e936. Date of Electronic Publication: 2023 Jul 18 (Print Publication: 2023).
DOI: 10.1097/HS9.0000000000000936
Abstrakt: The International Prognostic Score of thrombosis in Essential Thrombocythemia (IPSET-thrombosis) and its revised version have been proposed to guide thrombosis prevention strategies. We evaluated both classifications to prognosticate thrombosis in 1366 contemporary essential thrombocythemia (ET) patients prospectively followed from the Spanish Registry of ET. The cumulative incidence of thrombosis at 10 years, taking death as a competing risk, was 11.4%. The risk of thrombosis was significantly higher in the high-risk IPSET-thrombosis and high-risk revised IPSET-thrombosis, but no differences were observed among the lower risk categories. Patients allocated in high-risk IPSET-thrombosis (subdistribution hazard ratios [SHR], 3.7 [95% confidence interval, CI, 1.6-8.7]) and high-risk revised IPSET-thrombosis (SHR, 3.2 [95% CI, 1.4-7.45]) showed an increased risk of arterial thrombosis, whereas both scoring systems failed to predict venous thrombosis. The incidence rate of thrombosis in intermediate risk revised IPSET-thrombosis (aged >60 years, JAK2 -negative, and no history of thrombosis) was very low regardless of the treatment administered (0.9% and 0% per year with and without cytoreduction, respectively). Dynamic application of the revised IPSET-thrombosis showed a low rate of thrombosis when patients without history of prior thrombosis switched to a higher risk category after reaching 60 years of age. In conclusion, IPSET-thrombosis scores are useful for identifying patients at high risk of arterial thrombosis, whereas they fail to predict venous thrombosis. Controlled studies are needed to determine the appropriate treatment of ET patients assigned to the non-high-risk categories.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)
Databáze: MEDLINE
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