Validation of previous prognostic models for thrombosis and exploration of modified models in patients with essential thrombocythemia
Validation of previous prognostic models for thrombosis and exploration of modified models in patients with essential thrombocythemia
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DOI：
10.1111/ejh.13136
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发表时间：
2018-10-01
影响因子：
3.1
通讯作者：
Hino, Masayuki
中科院分区：
文献类型：
--
作者：
Hashimoto, Yoshinori;Nakamae, Hirohisa;Hino, Masayuki
目的：我们检查了预后因素，以验证以前的预后模型的生存和血栓形成与大规模的数据，日本患者原发性血小板增多症（ET）。方法：我们进行了一项研究，在352例ET患者，以验证以前的预后模型和寻找新的预后因素。结果：原发性血小板增多症国际预后评分（IPSET），在日本患者中证实了传统的风险分类和原发性血小板增多症血栓形成的国际预后评分（IPSET-T）是可重复的。然而，根据修订后的IPSET-T，在低风险和中等风险类别之间没有观察到显著差异，这不允许直接比较四个风险组。我们使用改良的IPSET-T重新评估了风险，该修订版IPSET-T是从修订的IPSET-T衍生而来的，对以下因素进行评分：年龄> 60岁1分，既往血栓形成史2分，JAK 2基因突变阳性2分; 0分=极低风险，1分=低风险，2分=中等风险，3分及以上=高风险，无血栓生存率有显著差异。改良的修订IPSET-T可用于4组分层，以预测需要治疗干预的人群，无论治疗方案如何。
Objective: We examined the prognostic factors to validate previous prognostic models for survival and thrombosis with large-scale data on Japanese patients with essential thrombocythemia (ET).Method: We conducted a study in 352 patients with ET to validate previous prognostic models and search for new prognostic factors.Results: The International Prognostic Score for essential thrombocythemia (IPSET), the conventional risk classification and the International Prognostic Score for thrombosis in essential thrombocythemia (IPSET-T) were confirmed to be reproducible in Japanese patients. However, no significant difference was observed between the low-risk and intermediate-risk categories according to the revised IPSET-T, which does not allow direct comparison of the four risk groups. We reevaluated the risk using a modified revised IPSET-T, which was derived from the revised IPSET-T by scoring the factors as follows: one point for age > 60 years, two points for past history of thrombosis, two points for JAK2 gene mutation-positive; total points of 0 = very low risk, 1 = low risk, 2 = intermediate risk, 3 and above = high risk, with significantly different thrombosis-free survival.Conclusion: The modified revised IPSET-T has been useful for 4-group stratification to predict a population that requires therapeutic intervention, irrespective of the treatment regimens.