Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
NU Hospital Group, Uddevalla, Sweden.
Eur J Haematol. 2023 Jun;110(6):608-617. doi: 10.1111/ejh.13938. Epub 2023 Feb 12.
The management to reduce risk of thromboembolic complications in polycythemia vera and essential thrombocythemia are well established, but for other conditions with elevated hemoglobin, hematocrit, or platelets there are no consensus regarding treatment and follow up.
To assess frequency of elevated blood values in patients with thromboembolic event, how many of these should be investigated further regarding myeloproliferative neoplasm and if the risk of recurrent event is depending on underlying condition.
Retrospective cohort study of 3931 adult patients in the county of Norrbotten, Sweden, with thromboembolism during 2017 and 2018.
Of the 3931 patients, 1195 had either elevated Hb, HCT, or platelets fulfilling the 2016 revised WHO criteria for PV and ET, and out of these 411 should be evaluated regarding underlying myeloproliferative neoplasms. Unexplained thrombocytosis and secondary erythrocytosis were associated with the highest rate of recurrent event as well as the most inferior restricted mean survival time.
Elevated blood values are common in patients with thromboembolic event and the high risk of recurrent event and inferior restricted mean survival time in patients with unexplained thrombocytosis and secondary erythrocytosis implicates the importance of finding and managing the underlying condition.
真性红细胞增多症和原发性血小板增多症中血栓栓塞并发症风险的管理已经成熟，但对于其他血红蛋白、血细胞比容或血小板升高的情况，关于治疗和随访尚没有共识。
评估血栓栓塞事件患者血液值升高的频率，有多少患者需要进一步调查骨髓增殖性肿瘤，以及复发事件的风险是否取决于潜在疾病。
对瑞典诺尔兰郡 2017 年至 2018 年期间发生血栓栓塞的 3931 例成年患者进行回顾性队列研究。
在 3931 例患者中，1195 例患者的 Hb、HCT 或血小板升高，符合 2016 年修订的 WHO 真性红细胞增多症和原发性血小板增多症标准，其中 411 例应评估潜在的骨髓增殖性肿瘤。不明原因的血小板增多症和继发性红细胞增多症与复发事件的发生率最高以及限制平均生存时间最短有关。
血栓栓塞事件患者的血液值升高很常见，不明原因的血小板增多症和继发性红细胞增多症患者的复发事件风险高且限制平均生存时间短，这表明发现和治疗潜在疾病的重要性。
