Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms.
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 ≤700×10(9)/L), leukocytosis (leukocytes >10×10(9)/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.
Hematology Institute "L. e A. Seragnoli", S. Orsola-Malpighi University Hospital, Bologna, Italy. Electronic address: luigi.gugliotta@unibo.it.
Luigi
L
Gugliotta
Hematology Dept., IRCCS Ca' Granda Foundation, University Polyclinic, Maggiore Hospital, Milano, Italy.
Alessandra
A
Iurlo
Hematology Institute "L. e A. Seragnoli", S. Orsola-Malpighi University Hospital, Bologna, Italy.
Gabriele
G
Gugliotta
Hematology Dept., Azienda Ospedaliera Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy.
Alessia
A
Tieghi
Hematology Dept., University Hospital Giovanni XXIII, Bari, Italy.
Giorgina
G
Specchia
Hematology Dept., Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
Gianluca
G
Gaidano
Hematology Dept., IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Potito R
PR
Scalzulli
Hematology Dept., IRCCS S. Matteo, University Hospital, Pavia, Italy.
Elisa
E
Rumi
Hematology Dept., S. Spirito Hospital, Pescara, Italy.
Alfredo
A
Dragani
Hematology Dept., University Federico II, Napoli, Italy.
Vincenzo
V
Martinelli
Cellular Biotechnologies and Hematology Dept., University "La Sapienza", Roma, Italy.
Cristina
C
Santoro
Internal Medicine Dept., DIMED, University Hospital, Padova, Italy.
Maria Luigia
ML
Randi
Hematology and Transfusion Dept., S. Giacomo Apostolo Hospital, Castelfranco Veneto, Italy.
Giuseppe
G
Tagariello
Hematology Dept., University Hospital S. Maria della Misericordia, Udine, Italy.
Anna
A
Candoni
Hematology Dept., IRCCS Ca' Granda Foundation, University Polyclinic, Maggiore Hospital, Milano, Italy.
Daniele
D
Cattaneo
Hematology Dept., University Hospital Giovanni XXIII, Bari, Italy.
Alessandra
A
Ricco
Hematology Unit, S. Giuseppe Moscati Hospital, Avellino, Italy.
Raffaele
R
Palmieri
Onco-Hematology Dept., S. Maria Hospital, Terni, Italy.
Marina A
MA
Liberati
Hematology Unit, Ospedale Civico, Nocera Inferiore, Italy.
Maria
M
Langella
Hematology Unit, S. Maria Goretti Hospital/ICOT, Latina, Italy.
Angela
A
Rago
Hematology Dept., University Hospital, Genova, Italy.
Micaela
M
Bergamaschi
Statistics Sciences Dept., University of Bologna, Bologna, Italy.
Paola
P
Monari
Statistics Sciences Dept., University of Bologna, Bologna, Italy.
Rossella
R
Miglio
Medical Technology Laboratory, Istituto Ortopedico Rizzoli-IRCCS, Bologna, Italy.
Umberto
U
Santoro
Dept. of Clinical and Molecular Biomedicine, Hemostasis Unit, University of Catania, Catania, Italy.
Rossella
R
Cacciola
Hematology Dept., University Hospital, Ancona, Italy.
Serena
S
Rupoli
Hematology Dept., San Gennaro/San giovanni Bosco Hospitals, Napoli, Italy.
Lucia
L
Mastrullo
IRCCS, Hematology Dept., CROB, Rionero in Vulture, Italy.
Pellegrino
P
Musto
Cellular Biotechnologies and Hematology Dept., University "La Sapienza", Roma, Italy.
Maria Gabriella
MG
Mazzucconi
Cellular Biotechnologies and Hematology Dept., University "La Sapienza", Roma, Italy.
Marco
M
Vignetti
Hematology Dept., IRCCS Ca' Granda Foundation, University Polyclinic, Maggiore Hospital, Milano, Italy.
Agostino
A
Cortelezzi
Hematology Institute "L. e A. Seragnoli", S. Orsola-Malpighi University Hospital, Bologna, Italy.
Nicola
N
Vianelli
Hematology Dept., Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy.
Bruno
B
Martino
Hematology Dept., Policlinico A. Gemelli, Università Cattolica, Roma, Italy.
Valerio
V
De Stefano
Hematology Dept., Az. Ospedaliera Universitaria, Ospedale di Circolo, Varese, Italy.
Francesco
F
Passamonti
Hematology Dept., University Hospital, Firenze, Italy.
Alessandro M
AM
Vannucchi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D007964:Leukocytosis; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000150:complications* / Q000175:diagnosis; D010976:Platelet Count; D012307:Risk Factors; D013922:Thrombocytosis / Q000150:complications*; D019851:Thrombophilia / Q000150:complications*; D013927:Thrombosis / Q000517:prevention & control; D055815:Young Adult
Hematocrit; JAK2; Leukocytes; Platelets; Thrombocythemia; Thrombosis