Sevindik Omur Gokmen, Mersin Sinan, Katgi Abdullah, Tunali Sunay, Solmaz Serife Medeni, Acar Celal, Alacacioglu Inci, Piskin Ozden, Ozcan Mehmet Ali, Demirkan Fatih, Undar Bulent, Ozsan Guner Hayri
Department of Hematology, Dokuz Eylul University, Izmir, Turkey.
Department of Internal Medicine, Dokuz Eylul University, Izmir, Turkey.
Clin Lymphoma Myeloma Leuk. 2015 Jun;15(6):e101-4. doi: 10.1016/j.clml.2015.02.004. Epub 2015 Feb 11.
Essential thrombocythemia (ET) is the most common of the myeloproliferative neoplasms. For better predicting the occurrence of thrombotic events, an International Prognostic Score of Thrombosis for ET (IPSET-Thrombosis) was recently developed. We aimed to investigate the validity of IPSET-Thrombosis in a Turkish patient cohort and to compare the efficacy of IPSET-Thrombosis and conventional risk scoring systems in predicting thrombosis-free survival.
We retrospectively evaluated the clinical characteristics and risk factors for thrombosis in 112 Turkish patients. Median thrombosis-free survival and Harrell C concordance indexes were calculated for both conventional and IPSET-Thrombosis.
Median age of 112 patients included in the study was 61 (range, 27-90) years at the time of diagnosis. When patients were stratified according to the conventional risk stratification system, 43.8% of patients were in the low-risk group and 56.2% in the high-risk group. A total of 22.4% of low-risk and 42.9% of high-risk patients had at least one thromboembolic event. When patients were stratified according to the IPSET-Thrombosis, 33% were in the low-risk group, 26.8% in the intermediate-risk group, and 40.2% in the high-risk group. Considering IPSET-Thrombosis risk groups, 5.4% of low-risk, 26.7% of intermediate-risk, and 66.2% of high-risk patients had at least one thromboembolic event. Regarding IPSET-Thrombosis risk groups, 10-year thrombosis-free survival was 86.8% for low-risk, 39.4% for intermediate-risk, and 32.9% for high-risk groups (P < .001). Harrell C concordance indexes of conventional and IPSET-Thrombosis were 0.60 and 0.77, respectively.
By validating the reproducibility of IPSET-Thrombosis in Turkish ET patients, we found that IPSET-Thrombosis identifies thrombosis-free survival better than the conventional risk stratification system.
原发性血小板增多症(ET)是最常见的骨髓增殖性肿瘤。为了更好地预测血栓事件的发生,最近制定了ET的国际血栓形成预后评分(IPSET-血栓形成)。我们旨在研究IPSET-血栓形成在土耳其患者队列中的有效性,并比较IPSET-血栓形成与传统风险评分系统在预测无血栓生存方面的疗效。
我们回顾性评估了112例土耳其患者的临床特征和血栓形成的危险因素。计算了传统评分系统和IPSET-血栓形成的中位无血栓生存期和Harrell C一致性指数。
纳入研究的112例患者诊断时的中位年龄为61岁(范围27-90岁)。根据传统风险分层系统对患者进行分层时,43.8%的患者属于低风险组,56.2%属于高风险组。低风险组中共有22.4%的患者和高风险组中42.9%的患者发生了至少一次血栓栓塞事件。根据IPSET-血栓形成对患者进行分层时,33%属于低风险组,26.8%属于中风险组,40.2%属于高风险组。考虑IPSET-血栓形成风险组,低风险组中5.4%的患者、中风险组中26.7%的患者和高风险组中66.2%的患者发生了至少一次血栓栓塞事件。关于IPSET-血栓形成风险组,低风险组的10年无血栓生存率为86.8%,中风险组为39.4%,高风险组为32.9%(P <.001)。传统评分系统和IPSET-血栓形成的Harrell C一致性指数分别为0.60和0.77。
通过验证IPSET-血栓形成在土耳其ET患者中的可重复性,我们发现IPSET-血栓形成在识别无血栓生存方面优于传统风险分层系统。