Navarro Luana Magalhães, Trufelli Damila Cristina, Bonito Debora Rodrigues, Del Giglio Auro, Bollmann Patricia Weinschenker
Assistant Physician, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Coordinator of the Oncology Service, Hospital de Ensino Padre Anchieta, São Bernardo do Campo, SP, Brazil.
Rev Assoc Med Bras (1992). 2016 Oct;62(7):647-651. doi: 10.1590/1806-9282.62.07.647.
: In patients with essential thrombocythemia (ET), the vascular complications contribute to morbidity and mortality. To better predict the occurrence of thrombotic events, an International Prognostic Score for Thrombosis in Essential Thrombocythemia (IPSET-thrombosis) has recently been proposed. We present the application of this score and compare its results with the usual classification system.
: We retrospectively evaluated the characteristics and risk factors for thrombosis of 46 patients with a diagnosis of ET seen in the last 6 years at Faculdade de Medicina do ABC (FMABC).
: Thrombosis in the arterial territory was more prevalent than in venous sites. We observed that cardiovascular risk factors (hypertension, hypercholesterolemia, diabetes mellitus, and smoking) were also risk factors for thrombosis (p<0.001). Age over 60 years and presence of JAK2 V617F mutation were not associated with the occurrence of thrombotic events. No patient classified by IPSET-thrombosis as low risk had a thrombotic event. Furthermore, using the IPSET-thrombosis scale, we identified two patients who had thrombotic events during follow-up and were otherwise classified in the low-risk group of the traditional classification. Leukocytosis at diagnosis was significantly associated with arterial thrombosis (p=0.02), while splenomegaly was associated with venous thrombotic events (p=0.01).
: Cardiovascular risk factors and leukocytosis were directly associated with arterial thrombosis. IPSET-thrombosis appears to be better than the traditional classification at identifying lower risk patients who do not need specific therapy.
在原发性血小板增多症（ET）患者中，血管并发症会导致发病和死亡。为了更好地预测血栓形成事件的发生，最近提出了原发性血小板增多症血栓形成国际预后评分（IPSET-血栓形成）。我们展示了该评分的应用，并将其结果与常用的分类系统进行比较。
我们回顾性评估了过去6年在ABC医学院（FMABC）确诊为ET的46例患者的血栓形成特征和危险因素。
动脉区域的血栓形成比静脉部位更为普遍。我们观察到心血管危险因素（高血压、高胆固醇血症、糖尿病和吸烟）也是血栓形成的危险因素（p<0.001）。60岁以上的年龄和JAK2 V617F突变的存在与血栓形成事件的发生无关。IPSET-血栓形成分类为低风险的患者均未发生血栓形成事件。此外，使用IPSET-血栓形成量表，我们确定了两名在随访期间发生血栓形成事件的患者，他们在传统分类中属于低风险组。诊断时白细胞增多与动脉血栓形成显著相关（p=0.02），而脾肿大与静脉血栓形成事件相关（p=0.01）。
心血管危险因素和白细胞增多与动脉血栓形成直接相关。在识别不需要特殊治疗的低风险患者方面，IPSET-血栓形成似乎比传统分类更好。
