[老年真性红细胞增多症患者的临床特征及预后分析]

[Clinical feature and prognosis analysis of elderly patients with polythemia vera].

作者信息

Xiao Xia, Zhao Mingfeng, Meng Juanxia, Li Qing, Mu Juan, Li Xin, Lü Hairong, Liu Pengjiang, Deng Qi, Geng Li, Li Yuming

机构信息

Tianjin First Central Hospital, Tianjin 300192, China.

Tianjin First Central Hospital, Tianjin 300192, China; Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2015 May 12;95(18):1374-7.

PMID:26178352

Abstract

OBJECTIVE

To analyze the clinical features of elderly patients with polythemia vera (PV).

METHODS

Statistical analyses were performed for the clinical features of 68 PV patients of age≥60 years and 72 PV patients of age<60 years from January 2009 to December 2013 in our hospital.

RESULTS

Compared with younger patients, elderly patients with PV had higher incidences of thrombosis (54.4% (37/68) vs 30.6% (22/72), P=0.004), more risk factors of cardio-cerebrovascular (63.2% (43/68) vs 36.1% (26/72), P=0.001), higher white blood cell counts ((13.9±3.8)×10(9)/L vs (7.8±2.2)×10(9)/L, P=0.000) and higher JAK2 V617F allele burden (62% (30%-81%) vs 41% (26%-63%), P=0.035). There was higher incidences of vascular complications in elderly patients with PV (54.4% (37/68) vs 30.6% (22/72), P=0.004). Myelofibrosis transformation occurred with higher frequency in elderly patients with PV (11.8% (8/68) vs 2.8% (2/72), P=0.039). And there was no significant difference in the frequency of leukemia transformation between elderly patients and younger patients (4.4% (3/68) vs 0 (0/72), P=0.112). There was higher mortality rate in elderly patients with PV (14.7% (10/86) vs 4.2% (3/72), P=0.032).

CONCLUSIONS

There are more risk factors in elderly patients with PV. The elderly patients with PV has high risk to complicat with thrombosis and transformated to myelofibrosis and leukemia. Prevention or delay of these complications is currently the goal of treatment, so that it could reduce the mortality rate and disease progression.

摘要

目的

分析老年真性红细胞增多症（PV）患者的临床特征。

方法

对我院2009年1月至2013年12月收治的68例年龄≥60岁的PV患者和72例年龄<60岁的PV患者的临床特征进行统计分析。

结果

与年轻患者相比，老年PV患者血栓形成发生率更高（54.4%（37/68）对30.6%（22/72），P=0.004），心血管危险因素更多（63.2%（43/68）对36.1%（26/72），P=0.001），白细胞计数更高（（13.9±3.8）×10⁹/L对（7.8±2.2）×10⁹/L，P=0.000），JAK2 V617F等位基因负荷更高（62%（30%-81%）对41%（26%-63%），P=0.035）。老年PV患者血管并发症发生率更高（54.4%（37/68）对30.6%（22/72），P=0.004）。老年PV患者骨髓纤维化转化发生率更高（11.8%（8/68）对2.8%（2/72），P=0.039）。老年患者与年轻患者白血病转化频率无显著差异（4.4%（3/68）对0（0/72），P=0.112）。老年PV患者死亡率更高（14.7%（10/86）对4.2%（3/72），P=0.032）。