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

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 i...

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Bibliographic Details
Published in:Blood 2012-08, Vol.120 (7), p.1409-1411
Main Authors: Campbell, Peter J., MacLean, Cathy, Beer, Philip A., Buck, Georgina, Wheatley, Keith, Kiladjian, Jean-Jacques, Forsyth, Cecily, Harrison, Claire N., Green, Anthony R.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brief Report
Clinical Trials and Observations
Follow-Up Studies
Hematologic and hematopoietic diseases
Hemorrhage - blood
Hemorrhage - etiology
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Medical sciences
Myeloid Neoplasia
Platelet Count
Prospective Studies
Risk Factors
Thrombocythemia, Essential - blood
Thrombocythemia, Essential - complications
Thrombosis - blood
Thrombosis - etiology
Vascular Diseases - blood
Vascular Diseases - etiology
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Summary: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.
ISSN:0006-4971
1528-0020
DOI:10.1182/blood-2012-04-424911