Gangat Naseema, Tefferi Ayalew, Thanarajasingam Gita, Patnaik Mrinal, Schwager Susan, Ketterling Rhett, Wolanskyj Alexandra P
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Eur J Haematol. 2009 Jul;83(1):17-21. doi: 10.1111/j.1600-0609.2009.01246.x. Epub 2009 Feb 19.
In the current study we describe cytogenetic findings as well as clinical correlates and long-term prognostic relevance of abnormal cytogenetics at the time of diagnosis of essential thrombocythemia (ET).
The study cohort consisted of a consecutive group of patients with ET who fulfilled the World Health Organization diagnostic criteria, and in whom cytogenetic analysis was performed at diagnosis.
A total of 402 patients were studied (median age, 56 yrs; median follow-up 70 months). The prevalence of abnormal cytogenetics at diagnosis was 7% (28 of 402). The most common cytogenetic anomalies were trisomy 9 (four patients), abnormal chromosome 1 (three patients) and trisomy 8 (two patients). Parameters at diagnosis that were significantly associated with abnormal cytogenetics included palpable splenomegaly (P = 0.03), current tobacco use (P = 0.04); venous thrombosis (P = 0.02), and anemia with a hemoglobin of <10 g/dL (P = 0.02); but did not include JAK2V617F mutation status, or advanced age. During follow up, patients with abnormal cytogenetics did not have shorter survival, or increased transformation to acute leukemia or myelofibrosis.
Cytogenetic anomalies at diagnosis are relatively uncommon in ET, and do not predict evolution into more aggressive myeloid disorders, or inferior survival.
在本研究中,我们描述了原发性血小板增多症(ET)诊断时的细胞遗传学发现、临床相关性以及异常细胞遗传学的长期预后相关性。
研究队列包括一组连续的符合世界卫生组织诊断标准且在诊断时进行了细胞遗传学分析的ET患者。
共研究了402例患者(中位年龄56岁;中位随访70个月)。诊断时异常细胞遗传学的发生率为7%(402例中的28例)。最常见的细胞遗传学异常是9号染色体三体(4例患者)、1号染色体异常(3例患者)和8号染色体三体(2例患者)。诊断时与异常细胞遗传学显著相关的参数包括可触及的脾肿大(P = 0.03)、当前吸烟(P = 0.04)、静脉血栓形成(P = 0.02)以及血红蛋白<10 g/dL的贫血(P = 0.02);但不包括JAK2V617F突变状态或高龄。在随访期间,细胞遗传学异常的患者没有较短的生存期,也没有增加向急性白血病或骨髓纤维化的转化。
ET诊断时的细胞遗传学异常相对不常见,并且不能预测向更具侵袭性的骨髓疾病的演变或较差的生存期。