Persistent leukocytosis in polycythemia vera is associated with disease evolution but not thrombosis.
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Leukemia, Myeloid, Acute
/ etiology
Leukocytosis
/ physiopathology
Male
Middle Aged
Myelodysplastic Syndromes
/ etiology
Polycythemia Vera
/ complications
Primary Myelofibrosis
/ etiology
Prognosis
Retrospective Studies
Survival Rate
Thrombosis
Young Adult
Journal
Blood
ISSN: 1528-0020
Titre abrégé: Blood
Pays: United States
ID NLM: 7603509
Informations de publication
Date de publication:
07 05 2020
07 05 2020
Historique:
received:
19
09
2019
accepted:
10
02
2020
pubmed:
29
2
2020
medline:
1
1
2021
entrez:
29
2
2020
Statut:
ppublish
Résumé
There are unresolved questions regarding the association between persistent leukocytosis and risk of thrombosis and disease evolution in polycythemia vera (PV), as much of the published literature on the topic does not appropriately use repeated-measures data or time-dependent modeling to answer these questions. To address this knowledge gap, we analyzed a retrospective database of 520 PV patients seen at 10 academic institutions across the United States. Taking hematologic laboratory data at ∼3-month intervals (or as available) for all patients for duration of follow-up, we used group-based trajectory modeling to identify latent clusters of patients who follow distinct trajectories with regard to their leukocyte, hematocrit, and platelet counts over time. We then tested the association between trajectory membership and hazard of 2 major outcomes: thrombosis and disease evolution to myelofibrosis, myelodysplastic syndrome, or acute myeloid leukemia. Controlling for relevant covariates, we found that persistently elevated leukocyte trajectories were not associated with the hazard of a thrombotic event (P = .4163), but were significantly associated with increased hazard of disease evolution in an ascending stepwise manner (overall P = .0002). In addition, we found that neither hematocrit nor platelet count was significantly associated with the hazard of thrombosis or disease evolution.
Identifiants
pubmed: 32107559
pii: S0006-4971(20)62050-X
doi: 10.1182/blood.2019003347
pmc: PMC7205813
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1696-1703Subventions
Organisme : NCI NIH HHS
ID : P01 CA108671
Pays : United States
Organisme : NHLBI NIH HHS
ID : P01 HL053762
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 by The American Society of Hematology.
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