The Institute of Hematology, Catholic University, Rome, Italy.
Am J Hematol. 2010 Feb;85(2):97-100. doi: 10.1002/ajh.21593.
There is evidence that leukocytosis is associated with an increased risk of first thrombosis in patients with polycythemia vera (PV) and essential thrombocythemia (ET). Whether it is a risk factor for recurrent thrombosis too is currently unknown. In the frame of a multicenter retrospective cohort study, we recruited 253 patients with PV (n = 133) or ET (n = 120), who were selected on the basis of a first arterial (70%) or venous major thrombosis (27.6%) or both (2.4%), and who were not receiving cytoreduction at the time of thrombosis. The probability of recurrent thrombosis associated with the leukocyte count recorded at the time of the first thrombosis was estimated by a receiver operating characteristic analysis and a multivariable Cox proportional hazards regression model. Thrombosis recurred in 78 patients (30.7%); multivariable analysis showed an independent risk of arterial recurrence (hazard ratio [HR] 2.16, 95% CI 1.12-4.18) in patients with a leukocyte count that was >12.4 x 10(9)/L at the time of the first thrombotic episode. The prognostic role for leukocytosis was age-related, as it was only significant in patients that were aged <60 years (HR for arterial recurrence 3.35, 95% CI 1.22-9.19).
有证据表明，白细胞增多与真性红细胞增多症（PV）和原发性血小板增多症（ET）患者首次血栓形成的风险增加有关。它是否也是复发性血栓形成的危险因素目前尚不清楚。在一项多中心回顾性队列研究中，我们招募了 253 名 PV（n=133）或 ET（n=120）患者，这些患者是基于首次动脉（70%）或静脉主要血栓形成（27.6%）或两者（2.4%）而选择的，并且在血栓形成时未接受细胞减少治疗。通过接收者操作特征分析和多变量 Cox 比例风险回归模型估计首次血栓形成时记录的白细胞计数与复发性血栓形成的概率之间的相关性。78 名患者（30.7%）发生了血栓复发；多变量分析显示，在首次血栓发作时白细胞计数>12.4 x 10(9)/L 的患者中，动脉复发的风险独立增加（危险比[HR]2.16，95%置信区间 1.12-4.18）。白细胞增多的预后作用与年龄相关，因为它仅在年龄<60 岁的患者中具有显著性（动脉复发的 HR 为 3.35，95%置信区间 1.22-9.19）。
