| Autor: |
Barbui, Tiziano, Carobbio, Alessandra, Thiele, Juergen, Gangat, Naseema, Rumi, Elisa, Rambaldi, Alessandro, Vannucchi, Alessandro M., Tefferi, Ayalew, Jeryczynski, Georg, Müllauer, Leonhard, Vaidya, Rakhee, Sulai, Nanna H., Pardanani, Animesh, Larson, Dirk R., Cazzola, Mario, Casetti, Ilaria, Finazzi, Guido, Pieri, Lisa, Gisslinger, Heinz, Gisslinger, Bettina |
| Předmět: |
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| Zdroj: |
Blood Cancer Journal; 12/15/2023, Vol. 13 Issue 1, p1-5, 5p |
| Abstrakt: |
We applied a parametric Markov five-state model, on a well-characterized international cohort of 1,545 patients with polycythemia vera (PV; median age 61 years; females 51%), in order to examine the impact of incident thrombosis on the trajectory of death or disease progression. At a median follow-up of 6.9 years, 347 (23%) deaths, 50 (3%) blast phase (BP), and 138 (9%) fibrotic (post-PV MF) transformations were recorded. Incident thrombosis occurred at a rate of 2.62% pt/yr (arterial 1.59% and venous 1.05%). The probability of death, in the first 10 years, for 280 (18%) patients who developed thrombosis during follow-up was 40%, which was two-fold higher than that seen in the absence of thrombosis or any other transition state (20%; p < 0.01); the adverse impact from thrombosis was more apparent for arterial (HR 1.74; p < 0.01) vs venous thrombosis (p=NS) and was independent of other fixed (i.e., age, prior venous thrombosis, leukocytosis) or time-dependent (i.e., progression to BP or MF) risk variables. The transition probability to post-PV MF increased over time, in a linear fashion, with a rate of 5% capped at 5 and 10 years, in patients with or without incident thrombosis, respectively. The impact of thrombosis on transition probability to death or post-PV MF tapered off beyond 10 years and appeared to reverse direction of impact on MF evolution at the 12-year time point. These observations suggest thrombosis in PV to be a marker of aggressive disease biology or a disease-associated inflammatory state that is consequential to both thrombosis and disease progression. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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