Prediction of thrombotic and hemorrhagic events during polycythemia vera or essential thrombocythemia based on leukocyte burden
Prediction of thrombotic and hemorrhagic events during polycythemia vera or essential thrombocythemia based on leukocyte burden
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DOI：
10.1016/j.thromres.2015.02.023
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发表时间：
2015-05-01
影响因子：
7.5
通讯作者：
Bang, Soo-Mee
中科院分区：
文献类型：
--
作者：
Lim, Yoojoo;Lee, Jeong-Ok;Bang, Soo-Mee
背景：有证据表明白细胞增多与真性红细胞增多症 (PV) 和原发性血小板增多症 (ET) 的血栓或出血并发症之间存在关联，但临床意义尚不清楚。目的：评估随访期间的白细胞负荷是否与 PV 和 ET 的血栓或出血事件相关。患者/方法：我们回顾性分析了盆唐首尔国立大学医院治疗的 PV 或 ET 患者， 韩国。随访期间白细胞的时间加权平均值被定义为白细胞负荷，并针对每位患者进行计算并在患者亚组之间进行比较。对每名发生事件的患者，将事件发生前 3 个月期间的白细胞负荷与整个随访期间的白细胞负荷进行比较。 结果：在 102 名 PV 或 ET 患者中，29 名患者发生了 35 起事件（16 起血栓事件，19 起出血事件）（中位随访时间为 54 个月）。发生事件的患者的白细胞负荷显着高于无事件的患者（12,015 x 10(3)/μL vs. 9,567 x 10(3)/μL，P = 0.003）。这种差异在 ET 患者中比在 PV 患者中更显着，在发生出血事件的患者中比在发生血栓事件的患者中更显着。在发生事件的患者中，事件前阶段的白细胞负荷高于整个随访期间（16,767 x 10(3)/μL vs. 12,015 x 10(3)/μL，P = 0.002）。在所有患者中，整个随访期间白细胞负荷达到11,000 x 10(3)/μL或更高是血管事件的独立危险因素。结论：在PV或ET患者中，病程期间白细胞负荷与血栓或出血事件发生率增加有关。 (C) 2015 Elsevier Ltd. 保留所有权利。
Background: Evidences suggest an association between leukocytosis and thrombotic or hemorrhagic complication in polycythemia vera (PV) and essential thrombocythemia (ET), but clinical implication is not well known.Objective: To evaluate whether leukocyte burden during follow-up is related to thrombotic or hemorrhagic events in PV and ET.Patients/Methods: We retrospectively analyzed patients with PV or ET treated at Seoul National University Bundang Hospital, Korea. Time-weighted averages of leukocytes during the follow-up period were defined as leukocyte burden and were calculated for each patient and compared between patient subgroups. In each patient with events, leukocyte burden for the 3-month period before the event was compared with that for the entire follow-up period.Results: In 102 patients with PV or ET, 35 events (16 thrombotic, 19 hemorrhagic) occurred in 29 patients (median follow-up, 54 months). Leukocyte burden were significantly higher in patients with events than in event-free patients (12,015 x 10(3)/mu L vs. 9,567 x 10(3)/mu L, P = 0.003). The difference was more prominent in ET patients than in PV patients, and in patients with hemorrhagic events than in those with thrombotic events. In patients with events, the leukocyte burden in the pre-event period was higher than in the entire follow-up period (16,767 x 10(3)/mu L vs. 12,015 x 10(3)/mu L, P = 0.002). In all patients, leukocyte burden during entire follow-up period of 11,000 x 10(3)/mu L or higher was an independent risk factor for vascular events.Conclusion: In PV or ET patients, leukocyte burden during disease course is related to increased incidence of thrombotic or hemorrhagic events. (C) 2015 Elsevier Ltd. All rights reserved.