Correlation of blood counts with vascular complications in essential thrombocythemia: analysis of the prospective PT1 cohort
Correlation of blood counts with vascular complications in essential thrombocythemia: analysis of the prospective PT1 cohort
复制标题
DOI：
10.1182/blood-2012-04-424911
复制
发表时间：
2012-08-16
期刊：
影响因子：
20.3
通讯作者：
Green, Anthony R.
中科院分区：
文献类型：
--
作者：
Campbell, Peter J.;MacLean, Cathy;Green, Anthony R.
原发性血小板增多症是一种骨髓增生性肿瘤，与血小板计数增加和血栓形成或出血风险有关。尽管血小板计数和并发症发生率之间的关联很小，但细胞减灭治疗旨在使血小板计数正常化。白细胞计数和血栓形成之间相关性的证据越来越多，但缺乏前瞻性数据。在本研究中，我们调查了血管并发症和21887纵向血细胞计数之间的关系，在一个前瞻性，多中心队列的776例原发性血小板增多症患者。校正混杂变量后，诊断时血细胞计数与未来并发症之间无相关性。然而，随访期间血小板计数超出正常范围与大出血的即时风险相关（P = 0.0005），但与血栓形成无关（P = 0.7）。随访期间WBC计数升高与血栓形成（P = 0.05）和大出血（P = 0.01）相关。这些数据意味着，在原发性血小板增多症的细胞减少的目的应该是保持血小板计数，可以说是白细胞计数，在正常范围内。本研究在国际标准随机对照试验编号注册处（www.isrctn.org）注册，编号为72251782。（血。2012;120（7）：1409-1411）
Essential thrombocythemia, a myeloproliferative neoplasm, is associated with increased platelet count and risk of thrombosis or hemorrhage. Cytoreductive therapy aims to normalize platelet counts despite there being only a minimal association between platelet count and complication rates. Evidence is increasing for a correlation between WBC count and thrombosis, but prospective data are lacking. In the present study, we investigated the relationship between vascular complications and 21 887 longitudinal blood counts in a prospective, multicenter cohort of 776 essential thrombocythemia patients. After correction for confounding variables, no association was seen between blood counts at diagnosis and future complications. However, platelet count outside of the normal range during follow-up was associated with an immediate risk of major hemorrhage (P = .0005) but not thrombosis (P = .7). Elevated WBC count during follow-up was correlated with thrombosis (P = .05) and major hemorrhage (P = .01). These data imply that the aim of cytoreduction in essential thrombocythemia should be to keep the platelet count, and arguably the WBC count, within the normal range. This study is registered at the International Standard Randomized Controlled Trials Number Registry (www.isrctn.org) as number 72251782. (Blood. 2012;120(7):1409-1411)