Phollarp Prachatip, Dankai Wiyada, Wongtakan Ornkamon, Niprapan Piangrawee, Punnachet Teerachat, Hantrakun Nonthakorn, Piriyakhuntorn Pokpong, Rattanathammethee Thanawat, Hantrakool Sasinee, Chai-Adisaksopha Chatree, Tantiworawit Adisak, Norasetthada Lalita, Lekawanvijit Suree, Rattarittamrong Ekarat
Department of Internal Medicine.
Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Blood Coagul Fibrinolysis. 2025 Sep 1;36(6):261-267. doi: 10.1097/MBC.0000000000001376. Epub 2025 Jun 27.
The primary aim was to determine the prevalence of aspirin resistance in JAK2 V617F-mutated essential thrombocythemia and polycythemia vera patients. Secondary objectives included analyzing risk factors for aspirin resistance including JAK2 V617F allele burden. This cross-sectional study included patients aged at least 18 years with JAK2 V617F-mutated essential thrombocythemia and polycythemia vera who were prescribed aspirin. Blood samples were taken to measure JAK2 V617F allele burden and serum thromboxane B2 (TXB2). Aspirin resistance was defined by serum TXB2 levels greater than 570 pg/ml. Clinical characteristics, laboratory data, JAK2 V617F allele burden, and treatment were analyzed to identify risk factors. Seventy-eight patients were enrolled, with 27 (34.6%) having essential thrombocythemia and 51 (65.4%) having polycythemia vera. The prevalence of aspirin resistance was 100%. Factors associated with high TXB2 levels included a history of stroke [95% confidence interval (CI): 1.11-12.34; P = 0.034], hydroxyurea dose at least 15 mg/kg/day (95% CI: 1.04-8.93; P = 0.043), and platelet count at least 400 000 cells/μl (95% CI: 1.75-18.86; P = 0.004). JAK2 V617F allele burden was not significantly correlated with high serum TXB2 ( r2 = 0.087, P = 0.45). The prevalence of aspirin resistance was 100% in JAK2 V617F-mutated polycythemia vera and essential thrombocythemia patients, based on serum TXB2 levels greater than 570 pg/ml. A history of stroke, hydroxyurea dose at least 15 mg/kg/day, and platelet count at least 400 000 cells/μl were associated with high TXB2 levels.
主要目的是确定JAK2 V617F突变的原发性血小板增多症和真性红细胞增多症患者中阿司匹林抵抗的患病率。次要目标包括分析阿司匹林抵抗的危险因素，包括JAK2 V617F等位基因负荷。这项横断面研究纳入了年龄至少18岁、患有JAK2 V617F突变的原发性血小板增多症和真性红细胞增多症且正在服用阿司匹林的患者。采集血样以测量JAK2 V617F等位基因负荷和血清血栓素B2（TXB2）。阿司匹林抵抗定义为血清TXB2水平大于570 pg/ml。分析临床特征、实验室数据、JAK2 V617F等位基因负荷和治疗情况以确定危险因素。共纳入78例患者，其中27例（34.6%）患有原发性血小板增多症，51例（65.4%）患有真性红细胞增多症。阿司匹林抵抗的患病率为100%。与高TXB2水平相关的因素包括中风病史[95%置信区间（CI）：1.11 - 12.34；P = 0.034]、羟基脲剂量至少15 mg/kg/天（95% CI：1.04 - 8.93；P = 0.043）以及血小板计数至少400 000个/μl（95% CI：1.75 - 18.86；P = 0.004）。JAK2 V617F等位基因负荷与高血清TXB2无显著相关性（r2 = 0.087，P = 0.45）。基于血清TXB2水平大于570 pg/ml，JAK2 V617F突变的真性红细胞增多症和原发性血小板增多症患者中阿司匹林抵抗的患病率为100%。中风病史、羟基脲剂量至少15 mg/kg/天以及血小板计数至少400 000个/μl与高TXB2水平相关。
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