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Correlation of blood counts with vascular complications in essential thrombocythemia: analysis of the prospective PT1 cohort

Identifieur interne : 005D51 ( Main/Exploration ); précédent : 005D50; suivant : 005D52

Correlation of blood counts with vascular complications in essential thrombocythemia: analysis of the prospective PT1 cohort

Auteurs : Peter J. Campbell [Royaume-Uni] ; Cathy Maclean [Royaume-Uni] ; Philip A. Beer [Royaume-Uni] ; Georgina Buck [Royaume-Uni] ; Keith Wheatley [Royaume-Uni] ; Jean-Jacques Kiladjian [France] ; Cecily Forsyth [Australie] ; Claire N. Harrison [Royaume-Uni] ; Anthony R. Green [Royaume-Uni]

Source :

RBID : Pascal:12-0349846

Descripteurs français

English descriptors

Abstract

Essential thrombocythemia, a myeloproliferative neoplasm, is associated with increased platelet count and risk of thrombosis or hemorrhage. Cytoreductive therapy aims to normalize platelet counts despite there being only a minimal association between platelet count and complication rates. Evidence is increasing for a correlation between WBC count and thrombosis, but prospective data are lacking. In the present study, we investigated the relationship between vascular complications and 21 887 longitudinal blood counts in a prospective, multicenter cohort of 776 essential thrombocythemia patients. After correction for confounding variables, no association was seen between blood counts at diagnosis and future complications. However, platelet count outside of the normal range during follow-up was associated with an immediate risk of major hemorrhage (P = .0005) but not thrombosis (P = .7). Elevated WBC count during follow-up was correlated with thrombosis (P = .05) and major hemorrhage (P=.01). These data imply that the aim of cytoreduction in essential thrombocythemia should be to keep the platelet count, and arguably the WBC count, within the normal range. This study is registered at the International Standard Randomized Controlled Trials Number Registry (www.isrctn.org) as number 72251782.

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Le document en format XML

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<div type="abstract" xml:lang="en">Essential thrombocythemia, a myeloproliferative neoplasm, is associated with increased platelet count and risk of thrombosis or hemorrhage. Cytoreductive therapy aims to normalize platelet counts despite there being only a minimal association between platelet count and complication rates. Evidence is increasing for a correlation between WBC count and thrombosis, but prospective data are lacking. In the present study, we investigated the relationship between vascular complications and 21 887 longitudinal blood counts in a prospective, multicenter cohort of 776 essential thrombocythemia patients. After correction for confounding variables, no association was seen between blood counts at diagnosis and future complications. However, platelet count outside of the normal range during follow-up was associated with an immediate risk of major hemorrhage (P = .0005) but not thrombosis (P = .7). Elevated WBC count during follow-up was correlated with thrombosis (P = .05) and major hemorrhage (P=.01). These data imply that the aim of cytoreduction in essential thrombocythemia should be to keep the platelet count, and arguably the WBC count, within the normal range. This study is registered at the International Standard Randomized Controlled Trials Number Registry (www.isrctn.org) as number 72251782.</div>
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<li>Oxfordshire</li>
<li>Île-de-France</li>
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<li>Birmingham</li>
<li>Cambridge</li>
<li>Londres</li>
<li>Oxford</li>
<li>Paris</li>
</settlement>
<orgName>
<li>Université d'Oxford</li>
<li>Université de Birmingham</li>
<li>Université de Cambridge</li>
</orgName>
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<name sortKey="Campbell, Peter J" sort="Campbell, Peter J" uniqKey="Campbell P" first="Peter J." last="Campbell">Peter J. Campbell</name>
</noRegion>
<name sortKey="Beer, Philip A" sort="Beer, Philip A" uniqKey="Beer P" first="Philip A." last="Beer">Philip A. Beer</name>
<name sortKey="Beer, Philip A" sort="Beer, Philip A" uniqKey="Beer P" first="Philip A." last="Beer">Philip A. Beer</name>
<name sortKey="Buck, Georgina" sort="Buck, Georgina" uniqKey="Buck G" first="Georgina" last="Buck">Georgina Buck</name>
<name sortKey="Campbell, Peter J" sort="Campbell, Peter J" uniqKey="Campbell P" first="Peter J." last="Campbell">Peter J. Campbell</name>
<name sortKey="Green, Anthony R" sort="Green, Anthony R" uniqKey="Green A" first="Anthony R." last="Green">Anthony R. Green</name>
<name sortKey="Green, Anthony R" sort="Green, Anthony R" uniqKey="Green A" first="Anthony R." last="Green">Anthony R. Green</name>
<name sortKey="Harrison, Claire N" sort="Harrison, Claire N" uniqKey="Harrison C" first="Claire N." last="Harrison">Claire N. Harrison</name>
<name sortKey="Maclean, Cathy" sort="Maclean, Cathy" uniqKey="Maclean C" first="Cathy" last="Maclean">Cathy Maclean</name>
<name sortKey="Maclean, Cathy" sort="Maclean, Cathy" uniqKey="Maclean C" first="Cathy" last="Maclean">Cathy Maclean</name>
<name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name>
</country>
<country name="France">
<region name="Île-de-France">
<name sortKey="Kiladjian, Jean Jacques" sort="Kiladjian, Jean Jacques" uniqKey="Kiladjian J" first="Jean-Jacques" last="Kiladjian">Jean-Jacques Kiladjian</name>
</region>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Forsyth, Cecily" sort="Forsyth, Cecily" uniqKey="Forsyth C" first="Cecily" last="Forsyth">Cecily Forsyth</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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