Diagnosis and management of non-clonal erythrocytosis remains challenging: a single centre clinical experience
| Autor: | Eva Drnovšek, Helena Podgornik, Matjaž Sever, Aleša Kristan, Nataša Debeljak, Irena Preložnik Zupan, Tanja Belčič Mikič, Saša Anžej Doma, Martina Fink |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Polycythaemia medicine.medical_specialty Pediatrics Congenital erythrocytosis Polycythemia Idiopathic erythrocytosis 03 medical and health sciences 0302 clinical medicine Phlebotomy Internal medicine medicine Humans Outpatient clinic Retrospective Studies Aspirin Hematology business.industry Secondary erythrocytosis Disease Management High-Throughput Nucleotide Sequencing General Medicine Middle Aged medicine.disease Algorithm 030220 oncology & carcinogenesis Next-generation sequencing Etiology Female Original Article business 030215 immunology medicine.drug |
| Zdroj: | Annals of Hematology |
| ISSN: | 1432-0584 0939-5555 |
| DOI: | 10.1007/s00277-021-04546-4 |
| Popis: | Erythrocytosis has a diverse background. While polycythaemia vera has well defined criteria, the diagnostic approach and management of other types of erythrocytosis are more challenging. The aim of study was to retrospectively analyse the aetiology and management of non-clonal erythrocytosis patients referred to a haematology outpatient clinic in an 8-year period using a 3-step algorithm. The first step was inclusion of patients with Hb > 185 g/L and/or Hct > 0.52 in men and Hb > 165 g/L and/or Hct > 0.48 in women on two visits ≥ two months apart, thus confirming true erythrocytosis. Secondly, polycythaemia vera was excluded and secondary causes of erythrocytosis (SE) identified. Thirdly, idiopathic erythrocytosis patients (IE) were referred to next-generation sequencing for possible genetic background evaluation. Of the 116 patients, 75 (65%) are men and 41 (35%) women, with non-clonal erythrocytosis 34/116 (29%) had SE, 15/116 (13%) IE and 67/116 (58%) stayed incompletely characterized (ICE). Patients with SE were significantly older and had significantly higher Hb and Hct compared to patients with IE. Most frequently, SE was attributed to obstructive sleep apnoea and smoking. Phlebotomies were performed in 56, 53 and 40% of patients in the SE, IE, and ICE group, respectively. Approx. 70% of patients in each group received aspirin. Thrombotic events were registered in 12, 20 and 15% of SE, IE and ICE patients, respectively. Congenital erythrocytosis type 4 (ECYT4) was diagnosed in one patient. The study demonstrates real-life management of non-clonal erythrocytosis which could be optimized using a 3-step diagnostic algorithm. |
| Databáze: | OpenAIRE |
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