A Study about the Relationship between Thrombotic Events and Peripheral Neutrophil-to-Lymphocyte Ratio in Patients with Newly Diagnosed Essential Thrombocythemia

Abstract To explore the role of neutrophil-to-lymphocyte ratio (NLR) in patients with newly diagnosed essential thrombocythemia (ET) and the relationship with thrombotic events.150 ET patients with ET from January 2013 to December 2017 were retrospectively enrolled in this study to investigate the risk factors of thrombosis and analyse the role of NLR in thrombotic events. The following parameters were evaluated: age, sex, blood routine examination, JAK2V617F mutation, cardiovascular risk factors, history of previous thrombosis, thrombosis during follow-up, examination and biopsy of bone marrow.Age(P=0.001) and JAK2 V617F mutation(P=0.003) were independent risk factors for thrombotic events at diagnosis after Logistic multivariate analysis. WBC count (P=0.047), NLR (P<0.001), age (P=0.037) and thrombosis at diagnosis (P=0.036) were independent risk factors for future thrombotic events and NLR was better for prediction of future thrombotic events than other risk factors in ROC curve. The thrombosis-free survival of thrombotic events in patients with higher NLR(median survival 22.3 months, 95% CI:17.8-26.8) was significantly shorter than that of patients with lower NLR(median survival 55.5 months, 95% CI:53.4-57.5) in Kaplan-Meier analysis (P<0.001). After 60 months of follow-up, patients with lower NLR had a thrombosis-free survival of 97.4%, while patients with higher NLR had a thrombosis-free survival of 46.7%. NLR at diagnosis was a better predictive parameter for future thrombotic events than other clinical parameters in ET patients, but was not associated with thrombosis at diagnosis. Disclosures No relevant conflicts of interest to declare.

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Impact of the Bag Exchange Procedure on Risk of Peritonitis

Peritoneal Dialysis International ◽

10.3747/pdi.2009.00117 ◽

2010 ◽

Vol 30 (4) ◽

pp. 440-447 ◽

Cited By ~ 46

Author(s):

Jie Dong ◽

Yuan Chen

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Cox Regression ◽

Face Mask ◽

First Episode ◽

Independent Risk Factors ◽

Randomized Control ◽

The Relationship ◽

Control Study

ObjectiveWe studied whether improper bag exchange predicts the first peritonitis episode in continuous ambulatory peritoneal dialysis (CAPD) patients.Patients and MethodsOur single-center prospective observational study of 130 incident urban CAPD patients who started peritoneal dialysis (PD) between March 2005 and August 2008 aimed to determine the relationship between bag exchange procedures examined at the 6th month of PD and risk for a first peritonitis episode. All patients were followed until a first peritonitis episode, censoring, or the end of the study.ResultsThese 130 patients experienced 22 first peritonitis episodes during the 14-month follow-up. During bag exchange evaluation, 51.5% of patients washed their hands improperly, 46.2% failed to check expiration date or bag leakage, and 11.5% forgot to wear a face mask and cap. Patients experiencing peritonitis were more likely to forget to wear a face mask and cap. In multivariate Cox regression model, not wearing a face mask and cap [hazard ratio (HR): 7.26; 95% confidence interval (CI): 2.6 to 20.1; p < 0.001] and having anemia (HR: 0.96; 95% CI: 0.94 to 0.99; p = 0.005) were independent risk factors for a first episode of peritonitis.ConclusionsNot wearing a face mask and cap and having anemia were independent risk factors for peritonitis. A further randomized control study needs to verify the correlation between improper bag exchange technique and peritonitis in PD patients.

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The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

Revista Romana de Medicina de Laborator ◽

10.2478/rrlm-2020-0001 ◽

2020 ◽

Vol 28 (1) ◽

pp. 29-38

Author(s):

Orsolya Mártha ◽

Daniel Balan ◽

Daniel Porav-Hodade ◽

Emőke Drágus ◽

Mihai Dorin Vartolomei ◽

...

Keyword(s):

Bladder Cancer ◽

Primary Tumor ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Free Survival ◽

Lymphocyte Ratio ◽

Kaplan Meier ◽

Muscle Invasive

AbstractIntroduction: The peritumoral inflammatory reaction has a substantial importance in the oncologic outcome of bladder cancer (BC). One biomarker proven to be practical and accessible is the NLR (neutrophil-to-lymphocyte ratio) for high risk non-muscle invasive bladder cancer (NMIBC). The aim of the study was to investigate the role of NLR as a prognostic biomarker for disease recurrence, progression and survival of p Ta (pathological assesment of the primary tumor) NMIBC.Material and Methods: In our retrospective study we included 54 patients with pTa NMIBC from a total of 235 patients who underwent transurethral resection of bladder tumor (TURBT) during two consecutive years: January 2007 - December 2008 [median follow-up 106 months (interquartile range-IQR 68-116)]. Criteria for inclusion were: primary tumor, low-grade, with NLR available at 2 weeks prior to TURBT. NLR was considered altered if higher than 3.Results: The median age of the patients included was 63 years (IQR 55 - 72). Most of the patients had NLR---lt---3 (37 patients). Median EORTC (European Organization of Research and Treatment of Cancer) Recurrence Score was 4 (IQR 1-6), while EORTC Progression Score was 3 (IQR 0-6), respectively. Recurrence occurred in 8 out of 54 (14.81 %) patients and progression was identified in 2 out of 54 (3.70 %) patients with muscle-invasive BC during follow-up. NLR---gt---3 was not associated with clinical and pathological factors. In multivariable Cox regression analyses NLR as a continuous variable was an independent predictive factor for recurrence. Recurrence-free survival (RFS) Kaplan-Meier analysis did not show a statistical significance between NLR groups: 82.67% vs. 64.12%, p=0.26. Kaplan-Meier analysis showed a lower Progression-free survival (PFS) in the NLR---gt---3 group: 94.12% vs. 100%, p=0.04. During follow-up (106 months) 18 patients deceased with no impact of NLR as a prognostic factor in multivariable analyses. Kaplan-Meier overall survival (OS) analysis showed a 10-year OS of 70.27% in the low NLR group compared with 58.82% in the high NLR group, p=0.45.Conclusion: In this cohort, high NLR was associated with high recurrence rate in patients with Ta NMIBC. In low-risk NMIBC NLR could represent a valid biomarker for clinical usage regarding the intensity of follow-up schedule.

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Xp11.2 Translocation Renal Cell Carcinoma: Clinical Characteristics and Potential Prognostic Predictors

Disease Markers ◽

10.1155/2021/5647933 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Jie Dong ◽

Weifeng Xu ◽

Zhigang Ji ◽

Boju Pan

Keyword(s):

Risk Factors ◽

Distant Metastasis ◽

Cox Regression ◽

Fibrinogen Level ◽

Progression Free Survival ◽

Adult Patients ◽

Free Survival ◽

Independent Risk Factors ◽

Xp11.2 Translocation

Background. Xp11.2 translocation renal cell carcinoma, a rare malignancy, has a higher prevalence in children than in adults. It is relatively indolent in children but manifests with an aggressive course in adults. Clinical characteristics and prognostic studies for adult patients are scarce due to its rarity. Methods. This retrospective single-center study consecutively enrolled 24 newly diagnosed Xp11.2 translocation RCC adult patients. Clinical presentations were recorded, and baseline laboratory results and follow-up data were collected. Possible risk factors for progression-free survival and overall survival were first scanned with chi-square tests and t -tests to compare patients who suffered from progression or death with who did not. Multivariate Cox regression was further utilized to identify independent risk factors. Results. Twenty-four adult patients (median age 32, range 16-73), with a male-to-female ratio of 1 : 1, was included from April 2010 to March 2020. After follow-up for 35.7 months (+/- months), seven patients died. With univariate analysis, higher C-reactive protein-to-albumin (CRP/Alb) ratio ( p = 0.028 ), higher baseline fibrinogen ( p = 0.006 ), and presence of distant metastasis ( p = 0.007 ) were associated with progression of the disease; higher preoperative fibrinogen ( p = 0.014 ) and distant metastasis ( p = 0.020 ) were associated with death. With multivariate Cox regression, only baseline fibrinogen level ( p = 0.001 ) was identified as an independent risk factor for progression-free survival; meanwhile, fibrinogen level ( p = 0.048 ) and distant metastasis ( p = 0.043 ) were identified as independent risk factors for survival. Conclusions. Overall, relatively high CRP/Alb ratios, fibrinogen, and distant metastasis were associated with a poor prognosis of Xp11.2 tRCC adult patients; among them, only baseline fibrinogen levels independently predicted the progression of Xp11.2 tRCC; thus, it may help to identify patients with worse progression or death risk.

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Usefulness of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as a predictor of disease-free survival in breast cancer: A cross-sectional study

F1000Research ◽

10.12688/f1000research.18094.1 ◽

2019 ◽

Vol 8 ◽

pp. 306

Author(s):

Yaala S. Al-Bairmany ◽

Adil S. Aqabi ◽

Farah H. Al-Hasnawi ◽

Alaa S. Al-Aawad

Keyword(s):

Disease Free Survival ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Free Survival ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

The Relationship ◽

Disease Free

Background: The relationship between neutrophil-lymphocyte ratio (NLR) with outcome is a complex issue. A high NLR reflects systemic inflammation. This study aimed to estimate the relationship between NLR, and platelet-lymphocyte ratio (PLR) in disease-free survival (DFS). Methods: This was a cross-sectional study in which we reviewed the patient files of 102 patients with breast cancer treated at the Babylon Oncology Center from January 2009 to September 2014, who had follow-up for at least 36 months. The following data were collected from patient files: age, diagnosis date, date of recurrence and/or metastasis, follow-up, histological tumor type, tumor size, node metastasis stage, histological differentiation degree, estrogen and/or progesterone receptor expression, HER2 neu status, and metastasis site. Results: The mean age of patients was 50.4 ± 11.7 years and lowest period of follow up was 40 months. Longest DFS was 62 months, with 5 years DFS in 52.5% of patients. Stage N0 was associated with a significantly higher DFS compared to stage N1. Isolated local recurrence was seen in 15% of patients and combined local recurrences with distant metastasis was observed 37%. NLR had the highest discrimination ability to predict recurrence and distant metastasis. Conclusion: An increase in NLR was associated with poor DFS, and it can therefore be a predictive and prognostic factor. NLR’s established prediction model warrants further investigation.

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Correlates of preschoolers’ screen time in China: parental factors

10.21203/rs.3.rs-1162022/v1 ◽

2022 ◽

Author(s):

Xinyao Wang ◽

Sunyue Ye

Keyword(s):

Risk Factors ◽

Screen Time ◽

Dose Effect ◽

Physical And Mental Health ◽

Parental Factors ◽

Factors Influencing ◽

Independent Risk Factors ◽

The Relationship

Abstract Background With the advent of the electronic age, the long-term screen time (ST) of preschoolers in China is relatively high and is on the rise, which is likely to affect preschoolers’ physical and mental health. This study aimed to explore the factors influencing ST in preschoolers, especially the role of parental factors, and to provide a basis for the prevention, control, and intervention of ST in preschoolers in China. Methods A questionnaire was completed by the parents of 1,546 preschoolers from four kindergartens in Pinghu City, Zhejiang Province, China, and a logistic regression model was used to analyze the correlates of excessive ST in preschoolers. Results A total of 43.8% of preschoolers, of which 50.3% were boys and 49.7% were girls, had > 1 hour/day of ST. For older preschoolers, greater screen accessibility, greater frequency of eating in front of a screen, longer ST of parents, and unclear rules of screen behavior were the risk factors for ST being > 1 hour/day (P < 0.05). After adjusting for confounders, the relationship between the ST of fathers and ST of preschoolers was still significant (P < 0.01), and the dose-effect relationship was observed (P < 0.001). Conclusion Prolonged parental ST (especially of fathers) and lack of rules for screen behavior of were independent risk factors for prolonged preschoolers’ ST in this study.

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A Randomized Clinical Trial of Lenalidomide and Dexamethasone with and without Autologous Stem Cell Transplant in Patients with Newly Diagnosed Multiple Myeloma: Interim Study Results,

Blood ◽

10.1182/blood.v118.21.4142.4142 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4142-4142 ◽

Cited By ~ 3

Author(s):

Lijun Dai ◽

Amy O'Sullivan ◽

Ryan Kennedy ◽

Mohammad Abbas ◽

Yongli Shuai ◽

...

Keyword(s):

Clinical Trial ◽

Multiple Myeloma ◽

Overall Survival ◽

Stem Cell ◽

Low Dose ◽

Progression Free Survival ◽

Newly Diagnosed ◽

Free Survival

Abstract Abstract 4142 Introduction: High dose chemotherapy combined with autologous stem cell transplantation (ASCT) as opposed to conventional chemotherapy improved progression free survival (PFS) and overall survival (OS) in multiple myeloma (MM) and is currently the standard of care for newly diagnosed MM patients less than 65 years old. Over the last decade, novel agents such as lenalidomide or bortezomib have dramatically improved MM outcomes with similar response rates as ASCT and the role of upfront ASCT has become more controversial. Therefore the goal of this randomized clinical trial is to determine the role of upfront ASCT in newly diagnosed myeloma patients receiving novel agent lenalidomide and low-dose dexamethasone induction. Methods: Patients aged ≥18 years with newly confirmed, measurable MM in stage 2 and 3 (Salmon Durie) and meeting CRAB criteria were enrolled. Patients were randomized to transplant (Arm A) or to non-transplant (Arm B). Patients in Arm A received 4 cycles of lenalidomide (25mg days 1 – 21) plus low-dose dexamethasone (40mg days 1,8,15,22) followed by ASCT conditioned with 200 mg/m2 melphalan (LD+ASCT); Arm B patients received 8 cycles of lenalidomide plus low-dose dexamethasone (LD alone). Both arms received stem cell collection after 4 cycles of therapy if patients achieved at least a partial remission (PR). Patients with stable disease (SD) or progressive disease (PD) went off study. The primary objective was to compare best response. The secondary endpoints included duration of response (DOR), progression free survival (PFS), overall survival (OS) and evaluation of secondary malignancies in both arms. Results: From February 2008 to May 2011, 44 patients with newly diagnosed MM were randomized. The patient characteristics were as follow: median age of the patients was 61.7 years (range 48∼75), 45.5% female and 55.5% male patients, ISS stage I 31%, II 51% and III 18%. 40 patients were eligible for evaluation and 20 patients were randomized to Arm A or Arm B, respectively. The data were analyzed according to latest IMWG response criteria (Blood. 2011 May 5;117(18):4691–5). In an intention to treat analysis, patients in Arm A (LD + ASCT), achieved a 100% Overall Response Rate (ORR) with 40% PR (n=8) and 60% Very Good Partial Response (VGPR) (n=12). In Arm B (LD only) the ORR was 75% (n=15), including 15% CR (n=3), 35% VGPR (n=7), 25% PR (n=5), 20% SD (n=4) and 5% PD (n=1). The ORR was significantly superior in the LD+ASCT group compared to LD alone (p=0.047). After a median follow-up of 25.3 months, 17 patients have PD (8 in LD+ASCT and 9 in LD alone), 6 have died (1 in LD+ASCT and 5 in LD alone). DOR, PFS and OS were not significantly different in both groups. OS showed a trend to be superior in patients treated with LD+ASCT (p=0.08). (Table 1). One patient in the LD+ASCT arm developed MDS 13 months after start of therapy. Conclusion: Our interim analysis of an ongoing clinical study suggests that treatment of newly diagnosed MM patients with lenalidomide plus low-dose dexamethasone induction followed by upfront ASCT resulted in significantly improved ORR. There was no difference in terms of DOR or PFS with a trend of superior OS in the LD+ASCT group. The study requires careful interpretation based on the low patient number and relatively short follow up, but supports the continued role of upfront consolidative ASCT in newly diagnosed MM patients. The incidence of secondary malignancy was low with the development of 1 MDS. Updated data on response and overall survival will be available at the time of presentation. Disclosures: Roodman: Amgen: Consultancy; Millennium Pharmaceuticals: Consultancy. Raptis:Millennium: Speakers Bureau; Celgene Corp: Speakers Bureau; Eisai: Speakers Bureau. Lentzsch:Celgene Corp: Consultancy, Research Funding; Onyx: Consultancy; Genzyme: Consultancy; prIME Oncology: Honoraria; Imedex: Honoraria; Clinical Care Options: Honoraria.

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Insufficient platelet inhibition and thromboembolic complications in patients with intracranial aneurysms after stent placement

Journal of Neurosurgery ◽

10.3171/2015.6.jns1511 ◽

2016 ◽

Vol 125 (2) ◽

pp. 247-253 ◽

Cited By ~ 15

Author(s):

Hongchao Yang ◽

Youxiang Li ◽

Yuhua Jiang

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Intracranial Aneurysms ◽

Platelet Inhibition ◽

Thromboembolic Complications ◽

Anterior Circulation ◽

Stent Treatment ◽

Independent Risk Factors ◽

The Relationship

OBJECT Insufficient platelet inhibition has been associated with an increased incidence of thromboembolic complications in cardiology patients undergoing percutaneous coronary intervention. Data regarding the relationship between insufficient platelet inhibition and thromboembolic complications in patients undergoing neurovascular procedures remain controversial. The purpose of this study was to assess the relationship of insufficient platelet inhibition and thromboembolic complications in patients with intracranial aneurysm undergoing stent treatment. METHODS The authors prospectively recruited patients with intracranial aneurysms undergoing stent treatment and maintained the data in a database. MRI with diffusion-weighted sequences was performed within 24 hours of stent insertion to identify acute ischemic lesions. The authors used thromboelastography to assess the degree of platelet inhibition in response to clopidogrel and aspirin. Univariate and multivariate logistic regression analysis was used to identify potential risk factors of thromboembolic complications. RESULTS One hundred sixty-eight patients with 193 aneurysms were enrolled in this study. Ninety-one of 168 (54.2%) patients with acute cerebral ischemic lesions were identified by diffusion-weighted MRI. In 9 (5.4%) patients with ischemic lesions, transient ischemic attack or stroke was found at discharge, and these complications were found in 11 (6.5%) patients during the follow-up period. The incidence of periprocedural thromboembolic complications increased with resistance to antiplatelet agents, hypertension, hyperlipidemia, complete occlusion, and aneurysm of the anterior circulation. The multivariate regression analysis demonstrated that the anterior circulation and adenosine diphosphate (ADP) inhibition percentage were independent risk factors of perioperative thromboembolic complications. The maximum amplitude and ADP inhibition percentage were independent risk factors for thromboembolic complications during the follow-up period. CONCLUSIONS The ADP inhibition percentage is related to thromboembolic complications after stent placement for intracranial aneurysms. The increase of the ADP inhibition may decrease the risk of thromboembolic complications.

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Preoperative Plasma Fibrinogen Level: An Independent Predictor for Survival in Adult Patients With Xp11.2 Translocation Renal Cell Carcinoma

10.21203/rs.3.rs-88927/v1 ◽

2020 ◽

Author(s):

Jie Dong ◽

Weifeng Xu ◽

Zhigang Ji ◽

Boju Pan

Keyword(s):

Risk Factors ◽

Distant Metastasis ◽

Fibrinogen Level ◽

Progression Free Survival ◽

Adult Patients ◽

Plasma Fibrinogen ◽

Plasma Fibrinogen Level ◽

Free Survival ◽

Independent Risk Factors

Abstract BackgroundXp11.2 translocation renal cell carcinoma (Xp11.2 RCC) is a rare malignancy which is more common in children than in adults. It manifests with an aggressive course in adults and relatively indolent in children. Prognostic studies for adult patients are scare for the rarity of the disease; and the prognostic value of preoperative plasma fibrinogen level awaits further illumination.MethodsThis retrospective single-center study enrolled 24 consecutive newly diagnosed Xp11.2 RCC adult patients. Clinical presentations, baseline laboratory results and follow-up data were collected. Possible risk factors for progression free survival (PFS) and overall survival (OS) were first scanned with chi-square tests and t-tests to compare patients who suffered from progression or death and who did not. Independent risk factors for survival were further investigated with multivariate Cox regression.ResultsTwenty-four adult patients (median age 32, range 16-73), with a male-to-female ratio of 12:12, was included from 2010.4 to 2020.3. After a mean follow-up of 35.7months, seven patients died. With univariate analysis, higher C-reactive protein-to-albumin ratio (p=0.028), higher baseline fibrinogen level (p=0.006), and presence of distant metastasis(p=0.007) were associated with progression of disease; higher preoperative fibrinogen level (p=0.014) and distant metastasis (p= 0.020) were associated with death. With multivariate Cox regression, only baseline fibrinogen level (p=0.001) was identified as an independent risk factor for progression free survival; meanwhile, fibrinogen level (p= 0.048) and distant metastasis (p= 0.043) were identified as independent risk factors for survival.ConclusionsPreoperative plasma fibrinogen level, a routinely tested parameter before surgery, is a promising tool for risk stratification in adult patients with Xp11.2 RCC.

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Initial Presentation and Prognostic Factors in 286 Patients with T-Cell Large Granular Lymphocyte Leukemia.

Blood ◽

10.1182/blood.v108.11.300.300 ◽

2006 ◽

Vol 108 (11) ◽

pp. 300-300 ◽

Cited By ~ 3

Author(s):

Grzegorz S. Nowakowski ◽

William G. Morice ◽

Clive S. Zent ◽

Susan M. Schwager ◽

Chin-Yang Li ◽

...

Keyword(s):

Risk Factors ◽

Prognostic Factors ◽

T Cell ◽

High Risk ◽

Median Survival ◽

Mayo Clinic ◽

Severe Neutropenia ◽

Newly Diagnosed ◽

Independent Risk Factors ◽

Lgl Leukemia

Abstract Background: The prognosis of patients with T-cell large granular lymphocyte (LGL) leukemia is diverse, with some patients experiencing rapid progression of the disease while others surviving decades. Despite multiple case reports and a number of case series reported in literature, prognostic factors in this leukemia are unknown and no staging/prognostic system has been developed. Aim: To identify factors predicting the prognosis of patients with newly diagnosed T-cell LGL leukemia. Methods: We reviewed the presentation, laboratory data and the clinical course of patients with newly diagnosed T-cell LGL at seen at the Mayo Clinic, Rochester. T-cell LGL was diagnosed in patients with at least 2 of these criteria: morphological evidence of LGL leukemia on bone marrow biopsy or blood smear; LGL immunophenotype; evidence of clonal T-cell receptor gene rearrangements. Results: 286 patients seen at Mayo Clinic Rochester between 6/1986 and 5/2005 met diagnostic criteria (52% male, median age at presentation 64 years (range 27–88)). Lymphadenopathy, splenomegaly, and hepatomegaly were present in 9%, 4% and 1.5% of the patients respectively. Median hemoglobin was 11.7 g/dL (range 3.5 – 17.1). Median absolute neutrophil count (ANC) was 1.51 × 109/L (range 0.0 – 20 × 109/L) and median absolute lymphocyte count (ALC) was 2.2 × 109/L (range 0.1 – 24). Median LGL count on peripheral smear was 0.81 × 109/L (range 0.06–10.8 × 109/L). Cytogenetic studies were done for 122 patients, of which, only 9 were abnormal. 87 patients (29%) had associated autoimmune conditions: rheumatoid arthritis (n=29), Felty’s syndrome (n=11), other connective tissue disorders (n=9)). Pure red cell aplasia, aplastic anemia, idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia were seen in 17, 5, 8, 1 patients respectively. Median follow up was 50 months (range 1–229) and estimated median survival was 74.3 months. In multivariate analysis, the only independent risk factors were: anemia (hemoglobin<12 g/dl), hazard ratio (HR) 1.75, (95%CI 1.22–2.52, p= 0.0023), severe neutropenia (<0.1 × 109/L), HR 2.11 (95%CI 1.053–4.25) and lymphopenia (ALC< 1 × 109/L), HR 1.93 (95%CI 1.21–3.07). We developed a simple prognostic scoring system based on the above identified independent risk factors, stratifying patients in 3 groups: 0 - no risk factors present, 1 -one risk factor, 2 - two or more risk factors present. The median survival was 105, 55 and 5 months for score of 0, 1 and 2 respectively, p=0.004 (Figure). Conclusion: The prognosis of patients with newly diagnosed T-cell LGL is variable. The presence of anemia, severe neutropenia and lymphopenia are independent poor prognostic factors in T-cell LGL. Combining these factors allows the identification of patients at a high risk of death from the disease. Further studies are needed to prospectively validate these findings and establish if the high risk group would benefit from aggressive therapy. Figure Figure.

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The Role of Previous Thrombotic Events in Patients with Essential Thrombocythemia: The Earlier the Worse?

Blood ◽

10.1182/blood.v120.21.5062.5062 ◽

2012 ◽

Vol 120 (21) ◽

pp. 5062-5062

Author(s):

Roberto Latagliata ◽

Marco Montanaro ◽

Michele Cedrone ◽

Nicoletta Villivà ◽

Raffaele Porrini ◽

...

Keyword(s):

Risk Factors ◽

Essential Thrombocythemia ◽

Thrombotic Event ◽

Cumulative Risk ◽

Group A ◽

Group B ◽

Retrospective Database ◽

Median Interval

Abstract Abstract 5062 Thrombotic events occurring before or at diagnosis of Essential Thrombocythemia (ET) are a worldwide recognized prognostic factor for the incidence of thrombosis during the follow-up of ET patients: however, these previous thrombotic events have been considered on the whole in the vast majority of studies, without further characterization. Among 1063 ET patients collected in the retrospective database of the “Gruppo Laziale SMPC Ph-”, we revised 186 cases with a previous thrombosis and a known data of occurrence, to evaluate the role of the interval from previous thrombotic episode and the diagnosis of ET. In 95 patients (51. 1%) previous thrombotic event occurred < 24 months before diagnosis of ET (group A) while in 91 patients (48. 9%) thrombosis occurred ≥ 24 months before diagnosis of ET (group B). Clinical features of patients at diagnosis are shown in the Table: GROUP A GROUP B p Gender (M/F) 40/55 42/49 0.636 Median age (yrs) (Interquartile range) (IR) 64.1 (52.7–71.8) 70.9 (61.0 – 78.0) 0.001 Hb median (g/dl) (IR) 13.9 (12.5 – 14.7) 14.2 (13.0 – 15.2) 0.136 PLT median (x 109/l) (IR) 800 (669 – 1066) 778 (652 – 926) 0.453 WBC median (x 109/l) (IR) 9.2 (7.8 – 11.3) 8.6 (7.1 – 10.8) 0.121 Median interval diagnosis – CHT (mos) (IR) 0.9 (0 – 7.0) 1.7 (0.4 – 5.6) 0.194 *CV risk factors (n°/%): 0.454 0 20 (21.0) 17 (18.6) 1 42 (44.2) 44 (48.3) ≥ 2 33 (34.8) 30 (33.1) Type of previous thrombosis (n°/%): 0.873 Arterial 78 (82.1) 67 (73.6) Venous 17 (17.9) 24 (26.4) * Cardiovascular (CV) risk factors at diagnosis were considered the presence of arterial hypertension, diabetes, smoking attitude, and hypercholesterolemia. In the group A, 9 out 95 patients (9. 4%) reported thrombotic episodes (5 arterial and 4 venous) during follow-up compared to 23 out 91 patients (25. 2%) (13 arterial and 10 venous) in the group B (p=0. 004). Consequently, patients of group B had a significantly higher cumulative risk of thrombosis compared to patients of group A (p=0. 0029, CI95% 1. 5 – 6. 1, RR 3. 04). In addition, it is worth of note that there was no difference in the cumulative risk of thrombosis between the patients of group A and the 877 patients without previous thrombotic events (p=0. 303, CI95% 0. 64 – 3. 21, RR 1. 24) In conclusion, the prognostic role of a previous thrombotic event in ET patients seems to be related not to the occurrence per se of the event but mainly to the interval between the event and the diagnosis of ET. Disclosures: Tafuri: Sigma Tau Pharmaceuticals: Research Funding.

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