| Abstrakt: |
Patients with essential thrombocythemia ( ET) often suffer from neurological symptoms ( NS) not ever resulting from previous thrombotic cerebral events ( TCE). We reported NS occurred in 282 patients, in order to identify the factors influencing ET-related NS in the absence of TCE, and the response to therapy. Overall, 116 of 282 patients (41%) presented NS; 101 of them (87%) reported subjective transient and fluctuating NS, without concurrent TCE, which we defined as ET-related NS, by frequency: cephalalgia, chronic paresthesias, dizziness or hypotension, visual disturbances, and tinnitus. In univariate analysis, ET-related NS resulted more frequently in young people ( P = 0.017) and in females ( P = 0.025). We found a higher prevalence of JAK2V617F mutation in ET-related NS patients ( P = 0.021). In multivariate analysis, gender ( P = 0.024) and JAK2 V617 F mutation ( P = 0.041) remained significantly associated with the development of ET-related NS, with a risk of about four times higher for JAK2 V617 F-mutated patients ( OR = 3.75). Ninety-seven of 101 patients with ET-related NS received an antiplatelet ( AP) agent at the time of NS, whereas only selected high-risk ET-related NS patients were treated with a cytoreductive drug, according to the published guidelines and similarly to patients without NS. We observed that only 32 of 97 (33%) patients with ET-related NS achieved a complete response after AP treatment. Among the 65 non-responder patients, 36 (55.4%) improved NS after the introduction of cytoreductive therapy; therefore, the addition of cytoreductive treatment should be considered in this setting. [ABSTRACT FROM AUTHOR] |
