We prospectively tested, at diagnosis in essential thrombocythemia (ET) patients with no clear indication to platelet (PLT)-lowering treatment, a scoring system based on age, PLT level, cardiovascular diseases, previous thrombotic events, smoking and dysmetabolic diseases. From 04/92 to 03/98, 168 consecutive patients were enrolled. Hydroxyurea (HU) was started at diagnosis in 32 "symptomatic" patients and in 33 patients aged > 70 years. The remaining 103 patients ("asymptomatic" and aged < 70 years) were classified according to our scoring system. Thirty-two patients with score a parts per thousand yen4 started HU early after diagnosis. The remaining 71 patients with score < 4 at diagnosis received anti-aggregating agents only; of them, 24 (33.8%) started HU during follow-up after a median time from diagnosis of 28 months, while 47 (66.2%) did not start any PLT-lowering treatment. Thrombotic complications occurred in 9/103 patients (8.7%); in particular, they occurred in 4/32 patients (12.5%) with score a parts per thousand yen4 receiving HU since diagnosis and in 5/71 (7%) with score < 4 under anti-aggregating agents only. This scoring system appears effective to discriminate a different risk of thrombotic events, and could be useful to decide when a PLT-lowering therapy needs to be started.
Decisional flow with a scoring system to start platelet-lowering treatment in patients with essential thrombocythemia: long-term results / Roberto, Latagliata; Angela, Rago; Antonio, Spadea; Santoro, Cristina; Ida, Carmosino; Massimo, Breccia; Napoleone, Laura; Angelo, Fama; Francesca, Biondo; Paola, Volpicelli; Federico, Vozella; Stefanizzi, Caterina; Maria Concetta, Petti; Alimena, Giuliana; Mazzucconi, Maria Gabriella. - In: INTERNATIONAL JOURNAL OF HEMATOLOGY. - ISSN 0925-5710. - 90:4(2009), pp. 486-491. [10.1007/s12185-009-0401-7]
Decisional flow with a scoring system to start platelet-lowering treatment in patients with essential thrombocythemia: long-term results
SANTORO, Cristina;Massimo Breccia;NAPOLEONE, LAURA;STEFANIZZI, CATERINA;ALIMENA, Giuliana;MAZZUCCONI, Maria Gabriella
2009
Abstract
We prospectively tested, at diagnosis in essential thrombocythemia (ET) patients with no clear indication to platelet (PLT)-lowering treatment, a scoring system based on age, PLT level, cardiovascular diseases, previous thrombotic events, smoking and dysmetabolic diseases. From 04/92 to 03/98, 168 consecutive patients were enrolled. Hydroxyurea (HU) was started at diagnosis in 32 "symptomatic" patients and in 33 patients aged > 70 years. The remaining 103 patients ("asymptomatic" and aged < 70 years) were classified according to our scoring system. Thirty-two patients with score a parts per thousand yen4 started HU early after diagnosis. The remaining 71 patients with score < 4 at diagnosis received anti-aggregating agents only; of them, 24 (33.8%) started HU during follow-up after a median time from diagnosis of 28 months, while 47 (66.2%) did not start any PLT-lowering treatment. Thrombotic complications occurred in 9/103 patients (8.7%); in particular, they occurred in 4/32 patients (12.5%) with score a parts per thousand yen4 receiving HU since diagnosis and in 5/71 (7%) with score < 4 under anti-aggregating agents only. This scoring system appears effective to discriminate a different risk of thrombotic events, and could be useful to decide when a PLT-lowering therapy needs to be started.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.