Leukocytosis is a risk factor for recurrent arterial thrombosis in young patients with polycythemia vera and essential thrombocythemia.
There is evidence that leukocytosis is associated with an increased risk of first thrombosis in patients with polycythemia vera (PV) and essential thrombocythemia (ET). Whether it is a risk factor for recurrent thrombosis too is currently unknown. In the frame of a multicenter retrospective cohort study, we recruited 253 patients with PV (n = 133) or ET (n = 120), who were selected on the basis of a first arterial (70%) or venous major thrombosis (27.6%) or both (2.4%), and who were not receiving cytoreduction at the time of thrombosis. The probability of recurrent thrombosis associated with the leukocyte count recorded at the time of the first thrombosis was estimated by a receiver operating characteristic analysis and a multivariable Cox proportional hazards regression model. Thrombosis recurred in 78 patients (30.7%); multivariable analysis showed an independent risk of arterial recurrence (hazard ratio [HR] 2.16, 95% CI 1.12-4.18) in patients with a leukocyte count that was >12.4 x 10(9)/L at the time of the first thrombotic episode. The prognostic role for leukocytosis was age-related, as it was only significant in patients that were aged <60 years (HR for arterial recurrence 3.35, 95% CI 1.22-9.19).
De Stefano
Valerio
V
The Institute of Hematology, Catholic University, Rome, Italy. valerio.destefano@rm.unicatt.it
Za
Tommaso
T
Rossi
Elena
E
Vannucchi
Alessandro M
AM
Ruggeri
Marco
M
Elli
Elena
E
Micò
Caterina
C
Tieghi
Alessia
A
Cacciola
Rossella R
RR
Santoro
Cristina
C
Gerli
Giancarla
G
Guglielmelli
Paola
P
Pieri
Lisa
L
Scognamiglio
Francesca
F
Rodeghiero
Francesco
F
Pogliani
Enrico M
EM
Finazzi
Guido
G
Gugliotta
Luigi
L
Leone
Giuseppe
G
Barbui
Tiziano
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013920:Thrombocythemia, Essential / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D013927:Thrombosis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy