title: Predictors of survival and cause of death in patients with essential thrombocythemia.
abstract: OBJECTIVE
  Standard risk stratification for overall survival (OS) in patients with essential thrombocythemia (ET) is based on advanced age and history of thrombotic events. Recently, International Prognostic Score for ET (IPSET) incorporated also leukocytosis in prognostic model. The aim of this study was to establish additional risk factors for OS in ET patients.
  
  
  METHODS
  After the median follow-up of 7 yr, in 244 consecutive ET patients, 32 deaths were documented (13.2%). The 5- and 10-yr OS was 95.9% and 79.7%, respectively. Considered additional risk factors at diagnosis of ET were the presence of arterial hypertension, diabetes, hyperlipidemia, and smoking attitude.
  
  
  RESULTS
  The main cause of death in 75% of patients was cardiovascular (CV) comorbidity. Patients with CV risk factors had increased risk of death (HR = 2.33). Cox regression model identified age, leukocytosis, presence of CV risk factors, and previous thrombosis as unfavorable predictors of survival. Based on these parameters, four risk groups were defined, with significantly different survivals (P < 0.001). Improved prognostic model displayed a better hazard ratio profile compared to the standard risk stratification and IPSET.
  
  
  CONCLUSIONS
  The addition of CV risk factors allows better prognostic assessment by delineating the intermediate-risk category and improved identification of the high-risk patients.
authors: Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Danijela
authors: D
authors: Lekovic
authors: Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia.|Medical Faculty, University of Belgrade, Belgrade, Serbia.
authors: Mirjana
authors: M
authors: Gotic
authors: Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Dijana
authors: D
authors: Sefer
authors: Institute for Medical Research, University of Belgrade, Belgrade, Serbia.
authors: Olivera
authors: O
authors: Mitrovic-Ajtic
authors: Institute for Medical Research, University of Belgrade, Belgrade, Serbia.
authors: Vladan
authors: V
authors: Cokic
authors: Medical Faculty, University of Belgrade, Belgrade, Serbia.|Institute for Medical Statistics, University of Belgrade, Belgrade, Serbia.
authors: Natasa
authors: N
authors: Milic
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000401:mortality / Q000628:therapy; D018572:Disease-Free Survival; D050171:Dyslipidemias / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000401:mortality / Q000628:therapy; D015996:Survival Rate; D013920:Thrombocythemia, Essential / Q000401:mortality* / Q000628:therapy
keywords: cardiovascular risk factors; essential thrombocythemia; myeloproliferative neoplasms; prognosis; survival