Holik Hrvoje, Krečak Ivan, Lucijanić Marko, Samardžić Ivan, Pilipac Danijel, Vučinić Ljubičić Ivana, Coha Božena, Kitter Pipić Alma, Miškić Blaženka, Zupančić-Šalek Silva
Department of Internal Medicine, Dr. Josip Benčević General Hospital, 35000 Slavonski Brod, Croatia.
Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
Life (Basel). 2023 Jun 14;13(6):1388. doi: 10.3390/life13061388.
Osteoarthritis (OA) is a progressive degenerative disease with an inflammatory background. Chronic myeloproliferative neoplasms (MPN) are clonal hematopoietic disorders characterized by chronic inflammation and a tendency for connective tissue remodeling.
This study aimed to investigate the prevalence and associated risk factors of symptomatic OA (sOA) in MPN patients.
A total of 100 consecutive MPN (39 essential-thrombocythemia, 34 polycythemia-vera, 27 myelofibrosis) patients treated in two community hematologic centers were cross-sectionally evaluated. Patients were required to have both symptoms attributable to hip and/or knee OA and radiographic confirmation to be considered as having sOA.
The prevalence of hip and/or knee sOA was significantly higher among MPN patients than the previously reported prevalence in the general population of similar age (61% vs. 22%, < 0.001). Hip sOA was present in 50%, knee sOA in 51% and sOA of both localizations in 41% of patients. A high proportion of MPN patients had radiographic signs of hip OA (94%) and knee OA (98%) in the presence of attributable symptoms. Among the other factors, sOA was univariately associated with the presence of mutation, myelofibrosis phenotype, older age, higher body weight, and higher MPN-SAF score ( < 0.050 for all analyses). In the multivariate analysis, older age (odds ratio = 1.19, 95% confidence interval-CI 1.06-1.33) and higher body weight (OR = 1.15, 95% CI 1.06-1.25) were recognized as independent risk factors for sOA. On the other hand, cytoreductive treatment was a protective factor for sOA (OR = 0.07, 95% CI 0.006-0.86).
The prevalence of sOA in MPN patients was higher than that in the general population and seems to correlate with older age, increased myeloproliferation and a higher inflammatory state. Whether cytoreductive treatment may postpone OA development in MPN patients warrants additional confirmation.
骨关节炎（OA）是一种具有炎症背景的进行性退行性疾病。慢性骨髓增殖性肿瘤（MPN）是一类克隆性造血疾病，其特征为慢性炎症和结缔组织重塑倾向。
本研究旨在调查MPN患者中症状性OA（sOA）的患病率及相关危险因素。
对在两个社区血液学中心接受治疗的100例连续MPN患者（39例原发性血小板增多症、34例真性红细胞增多症、27例骨髓纤维化）进行横断面评估。患者需同时具备髋部和/或膝部OA相关症状且经影像学证实，方可被视为患有sOA。
MPN患者中髋部和/或膝部sOA的患病率显著高于先前报道的相似年龄普通人群中的患病率（61%对22%，P<0.001）。50%的患者存在髋部sOA，51%的患者存在膝部sOA，41%的患者两个部位均存在sOA。在有相关症状的情况下，很大比例的MPN患者有髋部OA（94%）和膝部OA（98%）的影像学表现。在其他因素中，sOA在单因素分析中与 突变的存在、骨髓纤维化表型、年龄较大、体重较高以及较高的MPN-SAF评分相关（所有分析P<0.050）。在多因素分析中，年龄较大（比值比=1.19，95%置信区间-CI 1.06-1.33）和体重较高（OR = 1.15，95% CI 1.06-1.25）被认为是sOA的独立危险因素。另一方面，细胞减灭治疗是sOA的保护因素（OR = 0.07，95% CI 0.006-0.86）。
MPN患者中sOA的患病率高于普通人群，且似乎与年龄较大、骨髓增殖增加及炎症状态较高相关。细胞减灭治疗是否可延缓MPN患者OA的发展有待进一步证实。
