Thrombocytosis and leukocytosis interaction in vascular complications of essential thrombocythemia.
To elucidate the role of thrombocytosis, alone or in combination with standard (age, previous cardiovascular events) and novel (leukocytosis, JAK2(V617F) mutational status) risk factors, in the cardiovascular events of essential thrombocythemia (ET), we analyzed a cohort of 1063 patients. We found that a platelet count at diagnosis greater than 1000 x 10(9)/L was associated with significantly lower rate of thrombosis in multivariable analysis and, if combined with leukocytes less than 11 x 10(9)/L, pointed to a "low-risk" category with a rate of thrombosis of 1.59% of patients/year. On the contrary, the highest risk category (thrombosis rate, 2.95% of patients/year) was constituted of patients with leukocytosis, lower platelet count, and a JAK2(V617F) mutated genotype in most cases (77% vs 26% in the low-risk group), independently from standard risk factors. These data challenge the theory that elevated platelet count increases thrombosis risk in ET and suggest prospective clinical trials to support this hypothesis.
Carobbio
Alessandra
A
Department of Hematology, Ospedali Riuniti di Bergamo, Bergamo, Italy.
Finazzi
Guido
G
Antonioli
Elisabetta
E
Guglielmelli
Paola
P
Vannucchi
Alessandro M
AM
Delaini
Federica
F
Guerini
Vittoria
V
Ruggeri
Marco
M
Rodeghiero
Francesco
F
Rambaldi
Alessandro
A
Barbui
Tiziano
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000166:cytology; D007964:Leukocytosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012307:Risk Factors; D013920:Thrombocythemia, Essential / Q000150:complications* / Q000175:diagnosis*; D013922:Thrombocytosis / Q000150:complications / Q000175:diagnosis*