Essential thrombocythemia in young individuals: frequency and risk factors for vascular events and evolution to myelofibrosis in 126 patients: Chronic Myeloproliferative Disorders

The frequency of vascular events and evolution to myelofibrosis (MF) in young individuals with essential thrombocythemia (ET) is not well known. The incidence and predisposing factors to such complications was studied in 126 subjects diagnosed with ET at a median age of 31 years (range: 5–40). Overa...

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Veröffentlicht in:Leukemia 2007, Vol.21 (6), p.1218-1223
Hauptverfasser: Alvarez-Larrán, A, Cervantes, F, Bellosillo, B, Giralt, M, Juliá, A, Hernández-Boluda, J C, Bosch, A, Hernández-Nieto, L, Clapés, V, Burgaleta, C, Salvador, C, Arellano-Rodrigo, E, Colomer, D, Besses, C
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container_end_page 1223
container_issue 6
container_start_page 1218
container_title Leukemia
container_volume 21
creator Alvarez-Larrán, A
Cervantes, F
Bellosillo, B
Giralt, M
Juliá, A
Hernández-Boluda, J C
Bosch, A
Hernández-Nieto, L
Clapés, V
Burgaleta, C
Salvador, C
Arellano-Rodrigo, E
Colomer, D
Besses, C
description The frequency of vascular events and evolution to myelofibrosis (MF) in young individuals with essential thrombocythemia (ET) is not well known. The incidence and predisposing factors to such complications was studied in 126 subjects diagnosed with ET at a median age of 31 years (range: 5–40). Overall survival and probability of survival free of thrombosis, bleeding and MF were analyzed by the Kaplan–Meier method and the presence of the Janus Kinase 2 (JAK2) V617F mutation correlated with the appearance of such complications. The JAK2 mutation (present in 43% of patients) was associated with higher hemoglobin (Hb) ( P
doi_str_mv 10.1038/sj.leu.2404693
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The incidence and predisposing factors to such complications was studied in 126 subjects diagnosed with ET at a median age of 31 years (range: 5–40). Overall survival and probability of survival free of thrombosis, bleeding and MF were analyzed by the Kaplan–Meier method and the presence of the Janus Kinase 2 (JAK2) V617F mutation correlated with the appearance of such complications. The JAK2 mutation (present in 43% of patients) was associated with higher hemoglobin (Hb) ( P &lt;0.001) and lower platelets at diagnosis. With a median follow-up of 10 years (range: 4–25), 31 thrombotic events were registered (incidence rate: 2.2 thromboses/100 patients/year). When compared with the general population, young ET patients showed a significant increase in stroke (odds ratio 50, 95% CI: 21.5–115) and venous thromboses (odds ratio 5.3, 95% CI: 3.9–10.6). Thrombosis-free survival was 84% at 10 years, with tobacco use being associated with higher risk of thrombosis. Actuarial freedom from evolution to MF was 97% at 10 years. 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The incidence and predisposing factors to such complications was studied in 126 subjects diagnosed with ET at a median age of 31 years (range: 5–40). Overall survival and probability of survival free of thrombosis, bleeding and MF were analyzed by the Kaplan–Meier method and the presence of the Janus Kinase 2 (JAK2) V617F mutation correlated with the appearance of such complications. The JAK2 mutation (present in 43% of patients) was associated with higher hemoglobin (Hb) ( P &lt;0.001) and lower platelets at diagnosis. With a median follow-up of 10 years (range: 4–25), 31 thrombotic events were registered (incidence rate: 2.2 thromboses/100 patients/year). When compared with the general population, young ET patients showed a significant increase in stroke (odds ratio 50, 95% CI: 21.5–115) and venous thromboses (odds ratio 5.3, 95% CI: 3.9–10.6). Thrombosis-free survival was 84% at 10 years, with tobacco use being associated with higher risk of thrombosis. Actuarial freedom from evolution to MF was 97% at 10 years. In conclusion, young ET patients have thrombotic events, especially stroke and venous thrombosis, more frequently than generally considered, whereas they rarely transform to MF.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><doi>10.1038/sj.leu.2404693</doi></addata></record>
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source Nature; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Cancer Research
Critical Care Medicine
Hematology
Intensive
Internal Medicine
Medicine
Medicine & Public Health
Oncology
original-article
title Essential thrombocythemia in young individuals: frequency and risk factors for vascular events and evolution to myelofibrosis in 126 patients: Chronic Myeloproliferative Disorders
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