Essential Thrombocythemia: Analysis of Risk Factors for Thrombotic Events in a Series of 306 Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4937-4937
Author(s):  
Franca Radaelli ◽  
Stefania Bramanti ◽  
Mariangela Colombi ◽  
Alessandra Iurlo ◽  
Alberto Zanella
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Essential Thrombocythemia ◽  
Thrombotic Event ◽  
Previous History ◽  
Significant Difference ◽  
Platelet Number ◽  
History Of

Abstract Essential thrombocythemia (ET) is a chronic myeloproliferative disorder characterized by peripheral thrombocytosis and abnormal proliferation of megakariocytes in the bone marrow. Even thought thrombosis is frequently associated to ET, the risk factors of this clinical complication are still controversial. The aim of this retrospective, single institution study was to investigate clinical and laboratory characteristics associated with the occurrence of thrombotic events, with the purpose of identifying subgroups of patients who could benefit from antiaggregant and/or cytostatic treatment. 306 consecutive ET patients (109 men and 197 females, median age 58 yr) diagnosed between January 1979 and December 2002 were included in the study. At the time of analysis, 196 patients were still alive with a median follow up of 96 months. The following variables were investigated for the association with thrombotic complications: age, platelet count, previous history of thrombotic events, time from diagnosis, treatment with antiaggregant/cytostatic drugs, and cardiovascular risk factors such as arterial hypertension, obesity, hypercolesterolemia, diabetes, cigarette smoking. At the time of last follow up, 46 patients (15%) experienced at least one thrombotic event. The occurrence of thrombotic events was observed in 26/64 (40.6%) patients with previous history of thrombosis and in 20/242 (8.3%) patients with no previous history of thrombosis (p<0.0001 Fisher’s exact test, odd ratio 7.6). A significant difference between the two groups of patients was also confirmed when Kaplan Meier estimates of thrombosis-free survival were compared by log-rank test (p<0.0001). By logistic regression, platelet number at diagnosis did not associate with occurrence of thrombosis in the whole patient population. When patients without previous history of thrombosis were stratified according to the number of cardiovascular risk factors (none vs one vs more than one), a significant correlation with occurrence of thrombotic events was observed (Mantel-Haenszel Chi-square 5.47, p<0.05). This study confirms that history of thrombosis is strongly related with risk of further thrombotic events in patients with ET, whereas platelet number at diagnosis does not seem to represent a prognostic factor. In patients with no previous history of thrombosis, the presence of other cardiovascular risk factors has to be taken into account when establishing the therapeutic approach.

HIV may indirectly accelerate coronary artery disease through enhancing the effects of conventional and non-conventional cardiovascular risk factors

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kolossvary ◽  
E.K Fishman ◽  
G Gerstenblith ◽  
D.A Bluemke ◽  
R.N Mandler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Hiv Infection ◽  
Cardiovascular Risk Factors ◽  
Agatston Score ◽  
Funding Source ◽  
Significant Difference ◽  
Ascvd Risk ◽  
Artery Disease

Abstract Background/Introduction Cross-sectional studies are inconsistent on the potential independent adverse effects of human immunodeficiency virus (HIV)-infection on coronary artery disease (CAD). Furthermore, there is no information on the potential effects of HIV-infection on plaque volumes. Also, only the independent effects of HIV-infection on CAD have been investigated. Purpose In a prospective longitudinal observational cohort, we wished to assess whether HIV-infection accelerates CAD independently, or by acting in synergistic fashion with conventional and nonconventional cardiovascular risk factors to accelerate disease progression as assessed by clinical and volumetric parameters of CAD on coronary CT angiography (CCTA). Methods Overall, 300 asymptomatic individuals without cardiovascular symptoms but with CCTA-confirmed coronary plaques (210 males, age: 48.0±7.2 years) with or without HIV (226 HIV-infected) prospectively underwent CCTA at two time points (mean follow-up: 4.0±2.3 years). Agatston-score, number of coronary plaques, segment stenosis score were calculated, and we also segmented the coronary plaques to enumerate total, noncalcified (−100–350HU) and calcified (≥351HU) plaque volumes. Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use and high-sensitivity C-reactive protein on CCTA markers of CAD. Results In univariate analysis, there was no significant difference in CAD characteristics between HIV-infected and -uninfected, neither at baseline nor at follow-up (p>0.05 for all). Furthermore, there was no significant difference in annual progression rates between the two groups (p>0.05 for all). By multivariate analysis, HIV was not associated with any CAD parameter (p>0.05 for all). However, among HIV-infected individuals, each year of cocaine use significantly increased all CAD parameters (p<0.05 for all), while ASCVD risk score was significantly associated with CAD parameters except for Agatston-score (p<0.05). These associations were only present among HIV-infected individuals. Conclusion(s) Instead of directly worsening CAD, HIV may promote CAD through increased susceptibility to conventional and nonconventional cardiovascular risk factors. Therefore, aggressive management of both conventional and nonconventional cardiovascular risk factors is needed to reduce cardiovascular burden of HIV-infection. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health, National Institute on Drug Abuse

Risk Factors for Thrombosis Vary According to Age in Patients with Essential Thrombocythemia: a Retrospective Analysis of 1090 Patients from the “Gruppo Laziale SMPC Ph Negative “,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3854-3854
Author(s):  
Marco Montanaro ◽  
Roberto Latagliata ◽  
Michele Cedrone ◽  
Nicoletta Villivà ◽  
Raffaele Porrini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Thrombotic Event ◽  
Age Groups ◽  
Thrombotic Risk ◽  
Mutational Status ◽  
Group A ◽  
Group B

Abstract Abstract 3854 Increasing age is a well-recognised risk factor for thrombotic events in patients with Essential Thrombocythemia (ET): however, few data exist on the role of other clinical and biological features in different age groups. To address this issue, we analysed retrospectively 1090 ET patients (M/F 403/687, median age 63 years, IR 17 – 96) diagnosed at 11 Hematological Institutions in the Lazio region from 1980 to 2010 and with a median period of follow-up of 84 months (IR 1 – 371). Based on the commonly adopted age threshold, 480 patients (44 %) were < 60 years (Group A) and 610 (56 %) were ≥ 60 years (Group B). Clinical and biological features as well as cardiovascular risk factors analyzed for the impact on the thrombotic risk in the two age groups are reported in the Table.Group A < 60 yearsGroup B ≥ 60 yearsPutative risk factorsRisk ratio (95% CI)P valueRisk ratio (95% CI)P valueM/F167/3132.68 (1.03–6.94)0.0029236/3741.12 (0.17–2.59)0.73WBC median (range) x 109/l8.9 (4.29–22.35)0.387 (0.149–1,004)0.06458.9 (1.2–57.7)0.79 (0.41–1.47)0.445PLTS median (range) x 109/l837 (451–3582)0.37 (0.258–1.70)0.66802 (450–3104)0.52 (0.28–0.99)0.0052Hb median, g/dL (range)14.1 (6.0–18.4)0.86 (0.33–2.24)0.76914.0 (7.0–17.8)0.87 (0.45–1.67)0.674*JAK-2 mutational status: wild type/mutated (%)53.2/46.81.57 (0.50–4.87)0.4434.1/65.90.498 (0.17–1.48)0.209Previous thrombotic events: n° (%)· All events72 (15)2.18 (0.59–7.96)0.12149 (24.4)3.01 (1.38–6.57)0.0004· within 24 months from diagnosis48 (10)1.43 (0.19–10.4)0.7464 (10.5)0.506 (0.18–1.39)0.189· within 60 months from diagnosis60 (12.5)NA0.5191 (14.9)0.323 (0.11–0.95)0.023Cardiovascular risk factors: Y/N %○ Arterial hypertension41.7/58.31.68(0.64–4.36)0.2880.7/19.30.96 (0.36–2.57)0.935○ Diabetes10.2/89.81.11 (0.23–5.15)0.8925.0/75.01.09 (0.38–3.11)0.86○ Smoking attitude45.6/54.42.78 (1.01–7.65)0.06758.3/41.71.04 (0.35–3.09)0.94○ Hyperlipidemia31.0/69.03.11(0.917–10.592)0.03951.6/48.42.31 (0.70–7.55)0.203 In Group A, 39 patients (8.1%) had at least one thrombotic event during follow-up; there were 20 (51.3%) arterial thrombosis and 19 (48.7%) venous thrombosis. In Group B, 63 patients (10.3%) had at least one thrombotic event during follow-up; there were 38 (69.4%) arterial thromboses and 25 (39.6%) venous thromboses. In group A univariate analysis for thrombosis-free survival performed by Kaplan-Meier method, disclosed a significant impact of male gender (p=0.0029, CI 1.03–6.94, HR 2.68), > 2 cardiovascular risk factors (p=0.0002, CI 1.87 – 190, HR 18.94) and isolated hyperlipidemia (p=0.039, CI 0.917 – 10.59, HR 3.11), while previous thrombotic events had no significant impact (p=0.27). By contrast, the presence of a previous thrombotic event was the only feature with a significant impact on thrombotic risk in Group B (p=0.0004, CI 1.38 – 6.55, HR 3.01). WBC and PLTS values at different cut-off levels as well as JAK-2 mutational status did not have any impact on thrombosis in either age groups. However, in group B, we observed a trend (p=0.052, CI 0.28–0.99, HR 0.52) towards a protective effect of higher PLTS values (> 800 × 109/l). In conclusion, our data seem to reinforce the need of a different thrombotic risk assessment in distinct age groups: in particular, younger patients could benefit from early recognition and treatment of well-known cardiovascular risk factors. Disclosures: No relevant conflicts of interest to declare.

Abstract MP05: Impact of Gentrification on Cardiovascular Risk Factors and Outcomes in England: 2004-2018

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nrupen A Bhavsar ◽  
Danying Li ◽  
Miguel Ramos ◽  
Laura Richman
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
The United States ◽  
Living Environment ◽  
Length Of Residence ◽  
Lower Odds ◽  
Significant Difference ◽  
The Impact

Introduction: Dynamic changes to neighborhoods due to forces such as gentrification impact the health of residents. Much of this research has been conducted within the United States, where racial disparities and access to healthcare impact risk for health outcomes. Internationally, other factors may play a more prominent role in the association between gentrification and cardiovascular risk factors and outcomes. Hypothesis: Residents living in gentrified vs. non-gentrified neighborhoods will have lower odds of diabetes (DM), hypertension (HTN), depression and cardiovascular disease (CVD). Methods: We defined gentrification using changes in domains of the Index of Multiple Deprivation (IMD) at the level of the Lower Layer Super Output Areas (LSOA) in England from 2004-2010. We used all IMD domains (income, employment, education, crime, barriers to housing, and living environment), except the health domain, from 2004 and 2010 to define LSOA deprivation. The IMD for each LSOA was standardized to the mean IMD of England using z-scores. LSOAs were eligible to be gentrified if they had a positive z-score in 2004 and were considered to gentrify if they had a negative change in the transformed IMD from 2004 to 2010. We linked these data to individual participants in the Understanding Society Study (USS). The USS is a nationally representative cohort study of 60,000 United Kingdom residents started in 2009 with follow-up ongoing. We limited the analysis to residents in England who lived in top and bottom 25% deprived LSOAs (n=8782). We used multivariable logistic regression to calculate the odds ratio for self-reported DM, HTN, depression, and CVD in residents in neighborhoods that did and did not gentrify, adjusting for race, sex, length of residence (LOR), baseline IMD score, and baseline prevalence of health conditions. Results were stratified by age (<65 & >=65 years) and median LOR (<13 & >=13 years). Results: At baseline, 8782 participants had a median age of 43 years, 4% were black and 55% were female. There was no significant difference in the prevalence of DM, HTN, depression, or CVD at baseline. At follow-up, overall, there were no significant difference in the odds of DM, HTN, or CVD between residents living in gentrified vs. non-gentrified neighborhoods. Residents in neighborhoods that gentrified had a 39% lower odds of depression as compared to participants living in neighborhoods that did not gentrify (p=0.01). Results were not significantly modified by age or length of residence. Conclusions: Residents living in gentrified neighborhoods did not have differential risk for most CVD risk factors and outcomes as compared to residents living in neighborhoods that did not gentrify. However, the impact of gentrification on health is not uniform across all conditions. The positive health impact seen may suggest gentrification increases access to resources not present prior to gentrification.

scholarly journals CARDIOVASCULAR RISK IN ESSENTIAL THROMBOCYTHEMIA AND POLYCYTHEMIA VERA: THROMBOTIC RISK AND SURVIVAL

2020 ◽  
Vol 12 (1) ◽  
pp. e2020008
Author(s):  
Vincenzo Accurso ◽  
Marco Santoro ◽  
Salvatrice Mancuso ◽  
Angelo Davide Contrino ◽  
Paolo Casimio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cigarette Smoking ◽  
Cardiovascular Risk Factors ◽  
Polycythemia Vera ◽  
Essential Thrombocythemia ◽  
Thrombotic Event ◽  
Bleeding Events ◽  
Thrombotic Risk ◽  
The Impact

Abstract Thromboembolic and bleeding events pose a severe risk for patients with Polycythemia Vera (PV) and Essential Thrombocythemia (ET). Many factors can contribute to determine the thrombotic event, including the interaction between platelets, leukocytes and endothelium alterations. Moreover, a very important role can be played by cardiovascular risk factors (CV.R) such as cigarette smoking habits, hypertension, diabetes, obesity and dyslipidemia. In this study we evaluated the impact that CV.R plays on thrombotic risk and survival in patients with PV and ET.

scholarly journals Influence of ApoE Genotype and Clock T3111C Interaction with Cardiovascular Risk Factors on the Progression to Alzheimer’s Disease in Subjective Cognitive Decline and Mild Cognitive Impairment Patients

2020 ◽  
Vol 10 (2) ◽  
pp. 45 ◽  
Author(s):  
Valentina Bessi ◽  
Juri Balestrini ◽  
Silvia Bagnoli ◽  
Salvatore Mazzeo ◽  
Giulia Giacomucci ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cardiovascular Risk ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cardiovascular Risk Factors ◽  
Subjective Cognitive Decline ◽  
Apoe Ε4 ◽  
History Of

Background: Some genes could interact with cardiovascular risk factors in the development of Alzheimer’s disease. We aimed to evaluate the interaction between ApoE ε4 status, Clock T3111C and Per2 C111G polymorphisms with cardiovascular profile in Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI). Methods: We included 68 patients who underwent clinical evaluation; neuropsychological assessment; ApoE, Clock and Per2 genotyping at baseline; and neuropsychological follow-up every 12–24 months for a mean of 13 years. We considered subjects who developed AD and non-converters. Results: Clock T3111C was detected in 47% of cases, Per2 C111G in 19% of cases. ApoE ε4 carriers presented higher risk of heart disease; Clock C-carriers were more frequently smokers than non C-carriers. During the follow-up, 17 patients progressed to AD. Age at baseline, ApoE ε 4 and dyslipidemia increased the risk of conversion to AD. ApoE ε4 carriers with history of dyslipidemia showed higher risk to convert to AD compared to ApoE ε4− groups and ApoE ε4+ without dyslipidemia patients. Clock C-carriers with history of blood hypertension had a higher risk of conversion to AD. Conclusions: ApoE and Clock T3111C seem to interact with cardiovascular risk factors in SCD and MCI patients influencing the progression to AD.

Long Term Follow-up of 107 Patients with Essential Thrombocythemia: Role of Cardiovascular Events

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5566-5566
Author(s):  
Eleonora Arboscello ◽  
Elisa Molinari ◽  
Andrea Bellodi ◽  
Lisette Del Corso ◽  
Serena Favorini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Risk ◽  
Essential Thrombocythemia ◽  
Cardiovascular Events ◽  
Thrombotic Event ◽  
Improve Quality ◽  
History Of ◽  
The Impact

Abstract BACKGROUND Essential Thrombocythemia (ET) is a Philadelphia-negative chronic myeloproliferative neoplasm characterized by haemorrhagic and thrombotic complications. Haemorrhagic events and arterial and venous thrombosis, including microcirculation transient occlusions, are the major causes of morbidity in ET patients. The control of these events represents the goal of standard therapeutic approaches. MATERIALS AND METHODS We retrospectively analysed data about 107 ET patients who received diagnosis between January 1980 and June 2014. Median follow-up was 80 months,16 patients were lost during follow-up. The medium age at diagnosis was 60 years, with a prevalence of female (66 patients).We recorded adverse cardiovascular events at diagnosis and during follow-up, assessing whether cytoreductive ad antiplatelet therapy could reduce such events and improve quality of life. Finally, we evaluated the impact of additional cardiovascular risk factors. OBJECTIVES to observe incidence and kind of thrombotic events in patients affected by ET at diagnosis and during follow-up. RESULTS 30 patients (27.7%) had a history of thrombosis at diagnosis (8 transient cerebral ischemia, 7 myocardial infarction/unstable angina, among them 7 patients experienced a rethrombosis during follow-up. 16 patients (15%) developed a first thrombotic event, all patients were under cytoreductive treatment. 21 patients with a history of thrombosis had more than 60 years at diagnosis, 19 patients (63%) had at least one additional cardiovascular risk factor among arterial hypertension, dyslipidemia, diabetes, obesity, hyperuricemia and smoking. Median platelet count was 813000/mm3, leukocyte count greater was more than 10000/mm3 in half of patients. Evolution to acute leukemia/myelofibrosis occurred in 3 (2,7%) and 7 (6,5%) patients of total. CONCLUSIONS The occurrence of thrombotic events even in patients with good hematologic response of disease and during antiplatelet and cytoreductive therapy, indicates the presence of a residual risk of thrombosis. This risk is not yet fully clarified by retrospective studies published until now. Prospective studies will be useful to evaluate the role and the importance of comorbidity in these patients with long-prognosis, in order to optimize therapy, reduce cardiovascular events and improve quality of life Disclosures No relevant conflicts of interest to declare.

scholarly journals Cardiovascular risk factors in Saudi Arabian and non-Saudi Arabian diabetic patients in Saudi Arabia

2003 ◽  
Vol 9 (5-6) ◽  
pp. 884-892
Author(s):  
D. H. Akbar
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Blood Glucose Control ◽  
Saudi Arabian ◽  
University Hospital ◽  
Diabetic Patients ◽  
Significant Difference ◽  
King Abdulaziz University

To determine frequency of cardiovascular risk factors in Saudi and non-Saudi diabetics, we studied patients attending King Abdulaziz University Hospital for follow-up in the period January 1997 to December 2001. Cardiovascular risk factors, including hypertension, hyperlipidaemia, obesity and smoking, were studied as well as degree of blood glucose control. Of 1122 patients in the study, 48% were Saudis and 52% non-Saudis. No statistically significant difference was found for prevalence of cardiovascular risk factors between the two groups. Correlation of each of the risk factors to patient’s age showed significant correlation to hypertension and smoking

scholarly journals The natural history of cardiovascular risk factors in health professionals: 20-year follow-up

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Thiago Veiga Jardim ◽  
Ana Luiza Lima Sousa ◽  
Thais Inacio Rolim Povoa ◽  
Weimar Kunz Sebba Barroso ◽  
Brunela Chinem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Natural History ◽  
Cardiovascular Risk Factors ◽  
Health Professionals ◽  
History Of

Retrospective Analysis on 290 Patients with Polycythemia Vera Referred to a Single Transfusion Centre: Diagnosis Revision According to WHO Criteria and Evaluation of Survival and Complications According to Prognostic Factors and Treatment

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5229-5229
Author(s):  
Ermanno Venturino ◽  
Dario Ferrero ◽  
Elena Crisà ◽  
Mario Bazzan ◽  
Ausilia Ciocca ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diagnostic Criteria ◽  
Risk Group ◽  
Thrombotic Risk ◽  
Free Survival ◽  
Cytoreductive Treatment ◽  
History Of

Abstract Polycythemia vera (PV) is a myeloproliferative disorder strongly related to a mutated state of JAK2 tyrosine kynase. Several guide-lines have been published on diagnostic criteria and disease management. However, it is not well known if these recommendations are actually followed in the common clinical practice. Moreover, the recent large ECLAP study (Di Nisio et al.: Br J Haematol 2007) questioned the former strong recommendation of keeping the hematocrit (Hct) value below 0.45. We analysed 290 patients with a PV diagnosis made from January 1995 to December 2006 in different hematological institutions and referred to a single transfusion centre for phlebotomy. Among the whole casistics, 210 patients only satisfied 2001 or 2007 WHO diagnostic criteria for PV. This selected group of patients underwent further evaluation of clinical outcome. JAK2 V617F mutation was found in 80/83 of these patients. Median follow up from diagnosis was 68 months (range 13–161). The 210 patients included 115 males and 95 females with a median age of 65 years (range 18–92). Known risk factors at diagnosis comprehended history of previous thrombosis in 34 and concomitant cardiovascular risk factors (diabetes, smoking habit, hypertension, dyslipidemia) in 124 patients. According to the thrombotic risk stratification (Finazzi et al.: Blood 2005), 36 patients were in the low risk group, 29 in the intermediate one and 145 in the high risk group. All patients received phlebotomy at least in the first month from diagnosis. Eighty patients proceeded with phlebotomy only, whereas 130 also received a cytoreductive treatment for at least 6 months. Almost all patients (205: 98%) received either anti-platelets (195) and/or anti-coagulant (30) therapy. The main cytoreductive treatment was hydroxyurea (HU), used by 127 (97%) patients. In particular, HU was the only cytoreductive agent for 107 patients. Other drugs included pipobroman (18 patients), busulfan (5 patients), alpha interferon (2 patients) and 6-thioguanine (1 patient), used for intolerance or suboptimal response to HU. A thrombotic event was observed at diagnosis in 21 patients (10%). A correlation was observed between thrombosis at diagnosis and both thrombocytosis &gt; 600 × 109/l (p: &lt;0.001) and known cardiovascular risk factors (p: 0.03). During follow-up, seventeen patients died. Survival rate was 91.5% at the median follow-up of 68 months and is projected to reach 84% at 13 years. Overall survival was negatively influenced by age at diagnosis &gt; 65 years (p: &lt; 0.001), history of thrombosis before diagnosis (p: 0.05) and high risk score according to thrombotic risk stratification (p: 0.05). Forty-five patients (21%) displayed post-diagnosis thrombotic events at a median time of 41 months, which correlated to age at diagnosis &gt; 65 years (p: 0.006) and high thrombotic risk score (p: 0.04). Leukemic evolution occurred in 4 patients (2%), while secondary myelofibrosis and non-hematological neoplasia were observed in 8 and 11 patients, respectively. Chemotherapy administration did not affect neither overall nor thrombosis-free survival but correlated to neoplastic events (p: 0.05). Median Hct during follow up was kept at the recommended value &lt; 0.45 in 31 patients only (15%). Sixty-three % of patients maintained a median Hct value between 0.45 and 0.48 whereas 21.5 % had median Hct value &gt; 0.48. A Hct value &lt; 0.48 positively affected overall (p: 0.02) but not thrombosis-free survival. A possible advantage of keeping Hct value &lt; 0.45 could not be demonstrated due to the small number of patients in this group. In conclusion, diagnostic procedures were not found adherent to WHO indications in 80/290 (27%) patients with hypothetical PV diagnosis and in most of patients the Hct value could not be maintained below the recommended value. The importance of JAK2 evaluation as a diagnostic criteria was further underlined by the detection of V617F mutation in 96 % of the screened patients with a confirmed diagnosis of PV. Our casistics confirmed the role of known prognostic factors as age, previous thrombosis or concomitant cardiovascular risk factors, while the optimal Hct value during follow up (&lt; 0.45 or &lt; 0.48) and the true advantage of cytoreductive treatments remain to be established.

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