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真性红细胞增多症患者中一种潜在的新血栓栓塞事件评分系统:匈牙利费城阴性慢性骨髓增生性肿瘤登记处的审计。

A potentially new thromboembolic event scoring system in polycythaemia vera patients: An audit of the Hungarian Philadelphia negative chronic myeloproliferative neoplasia register.

机构信息

Department of Hematology of Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary.

St. Borbála Hospital, Tatabánya, Hungary.

出版信息

Eur J Haematol. 2023 Aug;111(2):263-270. doi: 10.1111/ejh.13992. Epub 2023 May 19.

Abstract

OBJECTIVE

The Hungarian National Registry for Philadelphia chromosome negative myeloproliferative neoplasms was used to analyse the thromboembolic events (TE) of Hungarian patients with polycythemia vera (PV).

METHODS

Data from 351 JAK2 V617F-positive patients diagnosed with PV were collected online from 15 haematology centres reporting clinical characteristics, therapeutic interventions and thromboembolic events. TE events were evaluated before and after diagnosis based upon the Landolfi and Tefferi risk assessment scales.

RESULTS

TE were reported on 102 patients before diagnosis and 100 during the follow-up period. Comparing to the frequency of major arterial events before PV diagnosis, we can notice a decreasing tendency after diagnosis: from 12.3% to 2.6% (p < .00003). There was no significant change in the rate of major venous events (from 5.1% to 8.5%; p = .1134) or minor arterial events (from 11.7% to 17.4%; p = .073). Bleeding events were recorded in 5.7% of patients. Despite treatment with HU + ASA, 44 patients (43.1%) with prior TE had recurrent thromboembolic complications. The particular analysis of our data revealed a new TE scoring system based on: age, gender, previous TE and iron deficiency at the time of diagnosis.

CONCLUSIONS

Our registry enables characterisation of patients with PV. The high level of recurrent TE events highlights the need for more effective and risk-adapted therapy.

摘要

目的

利用匈牙利费城染色体阴性骨髓增殖性肿瘤国家注册中心,分析真性红细胞增多症(PV)患者的血栓栓塞事件(TE)。

方法

从 15 家报告临床特征、治疗干预和血栓栓塞事件的血液学中心在线收集了 351 名 JAK2 V617F 阳性诊断为 PV 的患者的数据。根据 Landolfi 和 Tefferi 风险评估量表,在诊断前后评估 TE 事件。

结果

102 例患者在诊断前和 100 例患者在随访期间报告了 TE。与 PV 诊断前主要动脉事件的频率相比,我们可以注意到诊断后呈下降趋势:从 12.3%降至 2.6%(p<0.00003)。主要静脉事件(从 5.1%增至 8.5%;p=0.1134)或小动脉事件(从 11.7%增至 17.4%;p=0.073)的发生率没有显著变化。5.7%的患者有出血事件。尽管使用 HU+ASA 治疗,但 44 例(43.1%)有既往 TE 的患者仍发生复发性血栓栓塞并发症。对我们数据的特殊分析揭示了一种新的基于年龄、性别、既往 TE 和诊断时缺铁的 TE 评分系统。

结论

我们的登记册使 PV 患者的特征得以确定。高复发 TE 事件发生率强调了需要更有效和适应风险的治疗。

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