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Long‐term clinical outcomes of patients with hematologically unexplained cytopenia after routine assessment: A single center study
Author(s) -
Johansen Morten Munk,
Andersen Michael Asger,
Grønbæk Kirsten,
Hansen Jakob Werner
Publication year - 2018
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.13146
Subject(s) - medicine , cytopenia , cumulative incidence , incidence (geometry) , population , hazard ratio , standardized mortality ratio , cancer registry , cohort , comorbidity , cancer , confidence interval , bone marrow , physics , environmental health , optics
Objective We investigated mortality and long‐term development of malignant hematological disease, cancer, liver‐, renal‐, and rheumatic disease in patients with unexplained cytopenia ( UC ). Methods We screened all patients referred to the outpatient clinic at the Department of Hematology, Rigshospitalet, Copenhagen, with a suspected myeloid neoplasm from June 2009 to the end of 2012. Through registry linkage, we obtained information on hospital‐based ICD ‐10 diagnoses and survival. We estimated cumulative incidences of disease and hazard ratios of all‐cause mortality using the Aalen‐Johansen estimator and Cox regression. We compared incidences and mortality with a control cohort. Results Among 1820 referrals, 221 had UC . The UC group had a 5‐year cumulative incidence of malignant hematological disease of 8.91% ( CI 95%: 4.98‐12.84) compared to 0.93( CI 95%: 0.32‐1.55) in the matched controls. In addition, UC patients had higher incidences of cancer, liver, and rheumatic disease. Mortality was higher in UC patients compared to the matched controls with a HR of 1.43 [ P = 0.038, CI 95%: 1.02‐2.00] adjusted for comorbidity, sex, and age. Most of the mortality and morbidity were ascribed to patients 50 years or older. Conclusions Unexplained cytopenia patients had a higher incidence of malignant hematological‐, cancer‐, liver‐, and rheumatic disease and increased mortality compared to the general population.