title: [Clinical evaluation of the revised International Prognostic Score of Thrombosis for essential thrombocythemia (IPSET-thrombosis) in a cohort of 746 Chinese adult patients].
abstract: Objective:To evaluate the role of the revised International Prognostic Score of Thrombosis (IPSET-thrombosis) in predicting the occurrence of thrombotic events in Chinese patients with essential thrombocythemia (ET) and to develop a thrombosis predicting model more applicable to Chinese ET patients.Methods:Medical records of 746 adult patients with an initial diagnosis of ET were retrospectively analyzed.Results:The median age at diagnosis was 52 (18-87) years, with 305 males and 441 females. According to the revised IPSET-thrombosis model, the number of very low-, low-, intermediate-, and high-risk patients were 271 (36.3%) , 223 (29.9%) , 63 (8.4%) and 189 (25.3%) , respectively. The four groups exhibited significantly different thrombosis-free survival (χ(2)=72.301,P<0.001) . Thirty-six patients were reclassified as intermediate-risk according to the revised IPSET-thrombosis instead of low-risk as per the original IPSET-thrombosis. Nineteen intermediate-risk patients as per the original IPSET-thrombosis were upgraded to high-risk according to the revised IPSET-thrombosis. Fifty-one high-risk patients as per the original IPSET-thrombosis were reclassified as low-risk in the revised IPSET-thrombosis. It suggests that the revised IPSET-thrombosis potentially avoids over- or under-treatment. In low-risk patients as per the revised IPSET-thrombosis, the rate of thrombosis in patients with cardiovascular risk factors (CVF) was higher than that in those without (16.3%vs5.2%,χ(2)=5.264,P=0.022) , and comparable with intermediate-risk patients as per the revised IPSET-thrombosis (16.3%vs14.3%,χ(2)=0.089,P=0.765) . As a result, a new revised IPSET-thrombosis model more applicable to Chinese ET patients was developed in which patients with CVF in the low-risk group as per the revised IPSET-thrombosis were reclassified as intermediate-risk group.Conclusion:For predicting the occurrence of thrombotic events, the revised IPSET-thrombosis model was better than the original IPSET-thrombosis model. The revised IPSET-thrombosis was optimized and a new revised IPSET-thrombosis model more applicable to Chinese ET patients was developed, and the new evidence for risk stratification and treatment of ET in Chinese was provided.
authors.affiliation: Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: R F
authors.initials: RF
authors.lastname: Fu
authors.forename: H Y
authors.initials: HY
authors.lastname: Li
authors.forename: F
authors.initials: F
authors.lastname: Xue
authors.forename: X F
authors.initials: XF
authors.lastname: Liu
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.forename: Y T
authors.initials: YT
authors.lastname: Huang
authors.forename: Y F
authors.initials: YF
authors.lastname: Chen
authors.forename: L Y
authors.initials: LY
authors.lastname: Zhang
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: R C
authors.initials: RC
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002318:Cardiovascular Diseases; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013920:Thrombocythemia, Essential; D013927:Thrombosis; D055815:Young Adult
keywords: Mutation; Risk stratification; Thrombocythemia, Essential; Thrombosis