Observation versus antiplatelet therapy as primary prophylaxis for thrombosis in low-risk essential thrombocythemia

被引：176

作者：

Alvarez-Larran, Alberto ^{[1
]}

Cervantes, Francisco ^{[2
]}

Pereira, Arturo ^{[3
]}

Arellano-Rodrigo, Eduardo ^{[3
,4
]}

Perez-Andreu, Virginia ^{[5
]}

Hernandez-Boluda, Juan-Carlos ^{[6
]}

Ayats, Ramon ^{[7
]}

Salvador, Carlos ^{[8
]}

Muntanola, Ana ^{[9
]}

Bellosillo, Beatriz ^{[10
]}

Vicente, Vicente ^{[5
]}

Hernandez-Nieto, Luis ^{[11
]}

Burgaleta, Carmen ^{[12
]}

Xicoy, Blanca ^{[13
]}

Besses, Carlos ^{[1
]}

机构：

[1] Hosp Mar, Dept Hematol, Barcelona 08003, Spain

[2] Univ Barcelona, Dept Hematol, Hosp Clin, IDIBAPS, Barcelona, Spain

[3] Hosp Clin Barcelona, Hemotherapy & Hemostasis Serv, Barcelona, Spain

[4] Hosp Gen Valle Hebron, Dept Hematol, Barcelona, Spain

[5] Hosp Morales Messeguer, Dept Hematol, Murcia, Spain

[6] Hosp Clin, Dept Hematol, Valencia, Spain

[7] Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain

[8] Hosp Miguel Servet, Dept Hematol, Zaragoza, Spain

[9] Mutua Terrassa, Dept Hematol, Terrassa, Spain

[10] Hosp Mar, Dept Pathol, Barcelona 08003, Spain

[11] Hosp Univ Canarias, Dept Hematol, Tenerife, Spain

[12] Univ Alcala de Henares, Dept Hematol, Hosp Principe Asturias, Madrid, Spain

[13] Hosp Badalona Germans Trias & Pujol, Dept Hematol, Badalona, Spain

来源：

BLOOD | 2010年 / 116卷 / 08期

关键词：

TYROSINE KINASE JAK2; POLYCYTHEMIA-VERA; COMPLICATIONS; MUTATION; PREVENTION; EFFICACY; ASPIRIN; EVENTS; SAFETY;

D O I：

10.1182/blood-2010-01-263319

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The effectiveness of antiplatelet therapy as primary prophylaxis for thrombosis in low-risk essential thrombocythemia (ET) is not proven. In this study, the incidence rates of arterial and venous thrombosis were retrospectively analyzed in 300 low-risk patients with ET treated with antiplatelet drugs as monotherapy (n = 198) or followed with careful observation (n = 102). Follow-up was 802 and 848 person-years for antiplatelet therapy and observation, respectively. Rates of thrombotic events were 21.2 and 17.7 per 1000 person-years for antiplatelet therapy and observation, respectively (P = .6). JAK2 V617F-positive patients not receiving antiplatelet medication showed an increased risk of venous thrombosis (incidence rate ratio [IRR]: 4.0; 95% CI: 1.2-12.9; P = .02). Patients with cardiovascular risk factors had increased rates of arterial thrombosis while on observation (IRR: 2.5; 95% CI: 1.02-6.1; P = .047). An increased risk of major bleeding was observed in patients with platelet count greater than 1000 x 10(9)/L under antiplatelet therapy (IRR: 5.4; 95% CI: 1.7-17.2; P = .004). In conclusion, antiplatelet therapy reduces the incidence of venous thrombosis in patients with JAK2-positive ET and the rate of arterial thrombosis in patients with associated cardiovascular risk factors. In the remaining low-risk patients, this therapy is not effective as primary prophylaxis of thrombosis, and observation may be an adequate option. (Blood. 2010; 116(8): 1205-1210)

引用

页码：1205 / 1210

页数：6

共 28 条

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