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日本青少年和青年真性红细胞增多症和特发性血小板增多症的临床特征。

Clinical characteristics in adolescents and young adults with polycythemia vera and essential thrombocythemia in Japan.

机构信息

Department of Hematology and Oncology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.

Division of Molecular Hematology, Lund Stem Cell Center, Lund University, Lund, Sweden.

出版信息

Int J Hematol. 2024 Dec;120(6):684-693. doi: 10.1007/s12185-024-03862-5. Epub 2024 Oct 28.

Abstract

We report the first large-scale retrospective cohort study on adolescent and young adult (AYA) polycythemia vera (PV) and essential thrombocythemia (ET) in Japan, a subgroup analysis using Japanese multicenter registry data (JSH-MPN-R18). This study included patients with PV (n = 31) or ET (n = 141) aged 20 to 39 years at the initial visit. Hemorrhage-free survival (HFS) was better in AYA ET than in non-AYA ET (5-year HFS: 100% vs. 88.6%, p < 0.01), which might be attributed to differences in antithrombotic treatment rates between AYA and non-AYA patients. Although thrombosis-free survival did not differ statistically, the percentage of venous thrombotic events (TEs) among total TEs was higher in AYA compared to non-AYA PV and ET in Japan (26.0% vs. 6.0%, p < 0.01), but much lower than figures reported in European or US cohorts. Cytoreductive therapy (CRT) was administered to 25.8% of AYA patients with PV and 43.3% of AYA patients with ET, and the reason was usually unrelated to high risk of thrombosis. These results could be used to develop a more appropriate strategy for managing PV and ET in the Japanese AYA population.

摘要

我们报告了在日本进行的青少年和年轻成人(AYA)真性红细胞增多症(PV)和特发性血小板增多症(ET)的首次大规模回顾性队列研究,这是使用日本多中心登记处数据(JSH-MPN-R18)进行的亚组分析。本研究纳入了初诊时年龄为 20 至 39 岁的 PV(n=31)或 ET(n=141)患者。AYA ET 的无出血生存(HFS)优于非 AYA ET(5 年 HFS:100% vs. 88.6%,p<0.01),这可能归因于 AYA 和非 AYA 患者之间抗血栓治疗率的差异。虽然血栓形成无事件生存(TFE)无统计学差异,但在日本,AYA 与非 AYA PV 和 ET 相比,静脉血栓事件(TE)总数中的 TEs 百分比更高(26.0% vs. 6.0%,p<0.01),但远低于欧洲或美国队列的报告数据。PV 和 ET 的 AYA 患者分别有 25.8%和 43.3%接受了细胞减少治疗(CRT),其原因通常与血栓形成的高风险无关。这些结果可用于制定更适合日本 AYA 人群中 PV 和 ET 的管理策略。

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