Department of Translational and Precision Medicine, University "Sapienza" of Rome, Rome, Italy.
Department of Translational and Precision Medicine, University "Sapienza" of Rome, Rome, Italy.
Clin Lymphoma Myeloma Leuk. 2021 Apr;21(4):e328-e333. doi: 10.1016/j.clml.2020.11.003. Epub 2020 Nov 6.
According to 2008/2016 classification of the World Health Organization (WHO), a platelet (PLT) count ≥ 450 × 10/L, reduced from the previously published WHO 2001 indicated level ≥ 600 × 10/L, was considered the new PLT threshold for the diagnosis of essential thrombocythemia (ET).
To validate this important diagnostic change in a setting of current clinical practice, we retrospectively analyzed clinical and hematologic features at diagnosis and during follow-up of 162 patients with ET, diagnosed in our center from January 2008 to December 2017. We subdivided patients according to PLT value at baseline into Group A (PLT ≥ 600 × 10/L) (124 patients; 76.5%) and Group B (PLT ≥ 450 × 10/L < 600 × 10/L) (38 patients; 23.5%).
Among clinical features, only the median value of leukocytes (P < .001) was significantly higher in Group A. Cytostatic treatment was administered in 103 patients, with a significantly higher rate in patients of group A (P < .001). After a median follow-up of 42.4 months (interquartile range, 22.1-70.6 months), 8 thrombotic events were recorded in the entire cohort, without differences between the 2 groups (P = .336). The 5-year overall survival (OS) of the entire cohort was 96.9% (95% confidence interval, 92.6%-100%), without differences between the 2 groups (P = .255).
Our data indicate a substantial homogeneity among patients with ET regardless of the PLT count at diagnosis, thus confirming the usefulness of the 2008/2016 WHO diagnostic criteria.
根据世界卫生组织（WHO）2008/2016 年的分类，血小板（PLT）计数≥450×10/L，较之前发表的 WHO 2001 年规定的≥600×10/L有所降低，被认为是诊断原发性血小板增多症（ET）的新 PLT 阈值。
为了在当前临床实践环境中验证这一重要的诊断变化，我们回顾性分析了 2008 年 1 月至 2017 年 12 月期间在我院诊断为 ET 的 162 例患者的诊断时和随访期间的临床和血液学特征。我们根据基线时的 PLT 值将患者分为 A 组（PLT≥600×10/L）（124 例；76.5%）和 B 组（PLT≥450×10/L＜600×10/L）（38 例；23.5%）。
在临床特征中，仅 A 组白细胞的中位数（P＜0.001）显著更高。103 例患者接受了细胞抑制治疗，A 组患者的比例显著更高（P＜0.001）。在中位随访 42.4 个月（四分位间距，22.1-70.6 个月）后，整个队列中记录到 8 例血栓事件，两组间无差异（P=0.336）。整个队列的 5 年总生存率（OS）为 96.9%（95%置信区间，92.6%-100%），两组间无差异（P=0.255）。
我们的数据表明，无论诊断时的 PLT 计数如何，ET 患者之间存在实质性的同质性，从而证实了 2008/2016 年 WHO 诊断标准的有用性。
