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Leukocytosis in polycythemia vera and splenomegaly in essential thrombocythemia are independent risk factors for hemorrhage
Author(s) -
Chou YiSheng,
Gau JyhPyng,
Yu YuanBin,
Pai JihTung,
Hsiao LiangTsai,
Liu JinHwang,
Hong YingChung,
Liu ChunYu,
Yang ChingFen,
Chen PoMin,
Chiou TzeonJye,
Tzeng ChengHwai
Publication year - 2013
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12064
Subject(s) - medicine , leukocytosis , polycythemia vera , gastroenterology , incidence (geometry) , essential thrombocythemia , complication , univariate analysis , risk factor , cumulative incidence , surgery , multivariate analysis , cohort , physics , optics
Background Long‐term outcomes are favorable for patients with polycythemia vera ( PV ) and for patients with essential thrombocythemia ( ET ). However, hemorrhage is a significant cause of morbidity and mortality in those patients. Methods We retrospectively recruited 247 patients who had received a diagnosis of PV ( n = 101) or ET ( n = 146) during the period 2001–2010. Results After a median follow‐up period of 36.2 months, the cumulative incidence of hemorrhage was 39.6% in patients with PV (6.2% per person‐year) and 29.7% in patients with ET (5.9% person‐years). Episodes of major bleeding occurred in 9.9% of patients with PV and in 14.4% of patients with ET . Overall survival was significantly shorter among patients with hemorrhage than among those without said complication ( P < 0.001 for overall patients; P = 0.002 for patients with PV ; P = 0.026 for patients with ET ). In the univariate analysis, age ≥60 yr ( OR : 4.77, P = 0.046) and WBC ≥ 16 × 10 9 /L ( OR : 4.15, P = 0.010) were predictors of hemorrhage in patients with PV , and age ≥60 yr ( OR : 3.25, P = 0.040), WBC ≥ 16 × 10 9 /L ( OR : 2.89, P = 0.024), albumin <4.0 g/dL ( OR : 4.10, P = 0.002), and splenomegaly ( OR : 5.19, P = 0.002) were predictors of hemorrhage in patients with ET . Multivariate analysis showed that WBC ≥ 16 × 10 9 /L was the only significant risk factor for hemorrhage in patients with PV ( OR : 3.51, P = 0.026) and that splenomegaly was the only risk factor for hemorrhage in patients with ET ( OR : 3.00, P = 0.048). Conclusion Leukocytosis in PV and splenomegaly in ET are independent risk factors for hemorrhage.