In patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), the anti-thrombotic and/or cytoreductive treatment in the follow-up may affect the evaluation of the pro-thrombotic weight of the clinical and biological characteristics at diagnosis. In order to avoid this potential confounding effect, we investigated the relationship between prior thrombosis (PrTh: thrombosis occurred before diagnosis and before treatment) and the characteristics at diagnosis in 977 thrombocythemic patients with MPN, reclassified according to the WHO 2008 criteria. PrTh occurred in 194 (19.9%) patients, with similar rates in the different MPNs. In multivariate analysis, PrTh rate was significantly related to minor thrombocytosis (platelets ≤700 × 109/L), leukocytosis (leukocytes >10 × 109/L), higher hematocrit (HCT >45%), JAK2 V617F mutation, older age, and cardiovascular risk factors (CVRFs). The highest PrTh rate (33.9%) was associated with the coexistence of minor thrombocytosis and leukocytosis. Of note, the inverse relationship between PrTh rate and platelet count is consistent with the hemostatic paradox of thrombocytosis. In conclusion, this analysis in MPN patients disclosed the unbiased characteristics at diagnosis with a pro-thrombotic effect. Moreover, it suggests that the optimal control of blood cells counts, and CVRFs might be of utmost importance in the prevention of thrombosis during the follow-up. © 2016 Published by Elsevier Ltd.

Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms

PASSAMONTI, FRANCESCO
Penultimo
Writing – Original Draft Preparation
;
2016-01-01

Abstract

In patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), the anti-thrombotic and/or cytoreductive treatment in the follow-up may affect the evaluation of the pro-thrombotic weight of the clinical and biological characteristics at diagnosis. In order to avoid this potential confounding effect, we investigated the relationship between prior thrombosis (PrTh: thrombosis occurred before diagnosis and before treatment) and the characteristics at diagnosis in 977 thrombocythemic patients with MPN, reclassified according to the WHO 2008 criteria. PrTh occurred in 194 (19.9%) patients, with similar rates in the different MPNs. In multivariate analysis, PrTh rate was significantly related to minor thrombocytosis (platelets ≤700 × 109/L), leukocytosis (leukocytes >10 × 109/L), higher hematocrit (HCT >45%), JAK2 V617F mutation, older age, and cardiovascular risk factors (CVRFs). The highest PrTh rate (33.9%) was associated with the coexistence of minor thrombocytosis and leukocytosis. Of note, the inverse relationship between PrTh rate and platelet count is consistent with the hemostatic paradox of thrombocytosis. In conclusion, this analysis in MPN patients disclosed the unbiased characteristics at diagnosis with a pro-thrombotic effect. Moreover, it suggests that the optimal control of blood cells counts, and CVRFs might be of utmost importance in the prevention of thrombosis during the follow-up. © 2016 Published by Elsevier Ltd.
2016
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84963961981&partnerID=40&md5=ef88961ffbcbe6cace2c835dd0751f65
Hematocrit; JAK2; Leukocytes; Platelets; Thrombocythemia; Thrombosis
Gugliotta, L.; Iurlo, A.; Gugliotta, G.; Tieghi, A.; Specchia, G.; Gaidano, G.; Scalzulli, P. R.; Rumi, E.; Dragani, A.; Martinelli, V.; Santoro, C.; Randi, M. L.; Tagariello, G.; Candoni, A.; Cattaneo, D.; Ricco, A.; Palmieri, R.; Liberati, M. A.; Langella, M.; Rago, A.; Bergamaschi, M.; Monari, P.; Miglio, R.; Santoro, U.; Cacciola, R.; Rupoli, S.; Mastrullo, L.; Musto, P.; Mazzucconi, M. G.; Vignetti, M.; Cortelezzi, A.; Vianelli, N.; Martino, B.; De Stefano, V.; Passamonti, Francesco; Vannucchi, A. M.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2046346
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 11
  • ???jsp.display-item.citation.isi??? 10
social impact