Premium
Cytoreduction plus low‐dose aspirin versus cytoreduction alone as primary prophylaxis of thrombosis in patients with high‐risk essential thrombocythaemia: an observational study
Author(s) -
AlvarezLarrán Alberto,
Pereira Arturo,
ArellanoRodrigo Eduardo,
HernándezBoluda JuanCarlos,
Cervantes Francisco,
Besses Carlos
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12321
Subject(s) - medicine , aspirin , thrombosis , surgery , thrombocytosis , low dose aspirin , platelet
Summary The effectiveness of low‐dose aspirin in the primary prevention of thrombosis in patients with high‐risk essential thrombocythaemia ( ET ) treated with cytoreductive drugs is not well established. The risk‐benefit balance of low‐dose aspirin plus cytoreductive therapy compared with cytoreduction alone was retrospectively analysed in 247 patients with high‐risk ET without prior thrombosis. Follow‐up was 763 and 685 person‐years for cytoreduction plus low‐dose aspirin and cytoreduction alone, respectively. The rate of thrombosis was not significantly reduced in patients on cytoreduction plus aspirin (14·4 events per 1000 person‐years) when compared with those on cytoreduction alone (24·8 events per 1000 person‐years; P = 0·2). However, in the subgroup of patients older than 60 years, the addition of low‐dose aspirin was associated with a significantly lower rate of thrombosis (8·6 vs. 29·2 thrombosis per 1000 person‐years for combined treatment and cytoreduction alone, respectively, P = 0·02). The rate of major bleeding was significantly higher with combined therapy than with cytoreduction alone both in the whole series (14·4 vs. 1·4 haemorrhagic events per 1000 person‐years, respectively, P = 0·006) and in the subgroup of patients older than 60 years. In conclusion, low‐dose aspirin benefits high‐risk ET patients older than 60 years receiving cytoreductive therapy as primary prophylaxis of thrombosis.