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真性红细胞增多症和原发性血小板增多症中的血栓出血事件、疾病进展及生存情况:日本宫崎县的一项回顾性调查

Thrombohemorrhagic events, disease progression, and survival in polycythemia vera and essential thrombocythemia: a retrospective survey in Miyazaki prefecture, Japan.

作者信息

Kamiunten Ayako, Shide Kotaro, Kameda Takuro, Sekine Masaaki, Kubuki Yoko, Ito Masafumi, Toyama Takanori, Kawano Noriaki, Marutsuka Kousuke, Maeda Kouichi, Takeuchi Masanori, Kawano Hiroshi, Sato Seiichi, Ishizaki Junzo, Akizuki Keiichi, Tahira Yuki, Shimoda Haruko, Hidaka Tomonori, Yamashita Kiyoshi, Matsuoka Hitoshi, Shimoda Kazuya

机构信息

Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.

Japanese Red Cross Nagoya Daiichi Hospital, 3-35 Michishita-cho, Nakamura ku, Nagoya, 453-8511, Japan.

出版信息

Int J Hematol. 2018 Jun;107(6):681-688. doi: 10.1007/s12185-018-2428-0. Epub 2018 Feb 27.

Abstract

Polycythemia vera (PV) and essential thrombocythemia (ET) are associated with life-threatening thrombohemorrhagic events, and disease progression and development of non-hematological malignancies also reduce long-term survival. We retrospectively surveyed thrombohemorrhagic events and overall survival (OS) in 62 PV and 117 ET patients. The cumulative incidences of thrombohemorrhagic events in PV and ET patients were 11.3 and 10.3%, and the incidence rates were 2.42 and 1.85 per 100 person-years. The combined incidence rates of disease progression and development of non-hematological malignancies in PV and ET patients were 1.73 and 1.69 per 100 person-years. The incidence rates of thrombohemorrhagic events in our Japanese PV/ET patients were lower than those reported by most Western studies, but were comparable to those in the largest prospective observational study in ET patients. The combined incidence rates of disease progression and development of non-hematological malignancies were similar between Japanese and Western PV/ET patients. In ET patients, the conventional risk stratification model based on the presence of advanced age or history of thrombosis was useful to predict thrombosis risk, and both the conventional model and the International Prognostic Score of thrombosis in ET based on the above 2 risk factors plus increased leukocyte count could predict poor survival.

摘要

真性红细胞增多症(PV)和原发性血小板增多症(ET)与危及生命的血栓出血事件相关,疾病进展和非血液系统恶性肿瘤的发生也会降低长期生存率。我们回顾性调查了62例PV患者和117例ET患者的血栓出血事件及总生存期(OS)。PV和ET患者血栓出血事件的累积发生率分别为11.3%和10.3%,发病率分别为每100人年2.42例和1.85例。PV和ET患者疾病进展及非血液系统恶性肿瘤发生的合并发病率分别为每100人年1.73例和1.69例。我们日本PV/ET患者的血栓出血事件发病率低于大多数西方研究报道的发病率,但与ET患者最大规模的前瞻性观察研究中的发病率相当。日本和西方PV/ET患者疾病进展及非血液系统恶性肿瘤发生的合并发病率相似。在ET患者中,基于高龄或血栓形成病史的传统风险分层模型有助于预测血栓形成风险,基于上述两个风险因素加白细胞计数升高的传统模型和ET国际血栓形成预后评分均可预测不良生存。

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