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Predictors of survival and cause of death in patients with essential thrombocythemia
Author(s) -
Lekovic Danijela,
Gotic Mirjana,
Sefer Dijana,
MitrovicAjtic Olivera,
Cokic Vladan,
Milic Natasa
Publication year - 2015
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.12517
Subject(s) - essential thrombocythemia , medicine , leukocytosis , proportional hazards model , hazard ratio , diabetes mellitus , comorbidity , thrombocytosis , hyperlipidemia , polycythemia vera , confidence interval , platelet , endocrinology
Objectives Standard risk stratification for overall survival ( OS ) in patients with essential thrombocythemia ( ET ) is based on advanced age and history of thrombotic events. Recently, I nternational P rognostic S core for ET ( IPSET ) incorporated also leukocytosis in prognostic model. The aim of this study was to establish additional risk factors for OS in ET patients. Methods After the median follow‐up of 7 yr, in 244 consecutive ET patients, 32 deaths were documented (13.2%). The 5‐ and 10‐yr OS was 95.9% and 79.7%, respectively. Considered additional risk factors at diagnosis of ET were the presence of arterial hypertension, diabetes, hyperlipidemia, and smoking attitude. Results The main cause of death in 75% of patients was cardiovascular ( CV ) comorbidity. Patients with CV risk factors had increased risk of death ( HR = 2.33). Cox regression model identified age, leukocytosis, presence of CV risk factors, and previous thrombosis as unfavorable predictors of survival. Based on these parameters, four risk groups were defined, with significantly different survivals ( P < 0.001). Improved prognostic model displayed a better hazard ratio profile compared to the standard risk stratification and IPSET . Conclusion The addition of CV risk factors allows better prognostic assessment by delineating the intermediate‐risk category and improved identification of the high‐risk patients.