| Autor: |
Ruth Stuckey, Jean‐Christophe Ianotto, Marco Santoro, Anna Czyż, Manuel M. Perez Encinas, María Teresa Gómez‐Casares, Maria Soledad Noya Pereira, Anna Kulikowska de Nałęcz, Aleksandra Gołos, Krzysztof Lewandowski, Łukasz Szukalski, Jesús M. González‐Martín, Tomasz Wróbel, Marta Anna Sobas |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
British journal of haematologyREFERENCES. 199(1) |
| ISSN: |
1365-2141 |
| Popis: |
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 (aged60 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. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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