High platelet count at diagnosis is a protective factor for thrombosis in patients with essential thrombocythemia

Roberto Latagliata, Marco Montanaro, Michele Cedrone, Ambra Di Veroli, Francesca Spirito, Cristina Santoro, Sabrina Leonetti Crescenzi, Raffaele Porrini, Jonny Di Giandomenico, Nicoletta Villivà, Antonio Spadea, Angela Rago, Cinzia De Gregoris, Atelda Romano, Barbara Anaclerico, Marianna De Muro, Stefano Felici, Massimo Breccia, Enrico Montefusco, Antonino BagnatoGiuseppe Cimino, Ignazio Majolino, Maria Gabriella Mazzucconi, Giuliana Alimena, Alessandro Andriani, Gruppo Laziale, SMPC Ph1

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Abstract

To assess the role of platelet (PLT) count for thrombotic complications in Essential Thrombocythemia (ET), 1201 patients followed in 11 Hematological centers in the Latium region were retrospectively evaluated. At multivariate analysis, the following factors at diagnosis were predictive for a worse Thrombosis-free Survival (TFS): the occurrence of previous thrombotic events (p=0.0004), age>60years (p=0.0044), spleen enlargement (p=0.042) and a lower PLT count (p=0.03). Receiver Operating Characteristic (ROC) analyses based on thrombotic events during follow-up identified a baseline platelet count of 944×109/l as the best predictive threshold: thrombotic events were 40/384 (10.4%) in patients with PLT count >944×109/l and 109/817 (13.3%) in patients with PLT count <944×109/l, respectively (p=0.04). Patients with PLT count <944×109/l were older (median age 60.4years. vs 57.1years., p=0.016), had a lower median WBC count (8.8×109/l vs 10.6×109/l, p<0.0001), a higher median Hb level (14.1g/dl vs 13.6g/dl, p<0.0001) and a higher rate of JAK-2-V617F positivity (67.2% vs 41.6%, p<0.0001); no difference was observed as to thrombotic events before diagnosis, spleen enlargement and concomitant Cardiovascular Risk Factors. In conclusion, our results confirm the protective role for thrombosis of an high PLT count at diagnosis. The older age and the higher rate of JAK-2 V617F positivity in the group of patients with a baseline lower PLT count could in part be responsible of this counterintuitive finding.

Original languageEnglish
Pages (from-to)168-171
Number of pages4
JournalThrombosis Research
Volume156
DOIs
Publication statusPublished - Aug 2017

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Latagliata, R., Montanaro, M., Cedrone, M., Di Veroli, A., Spirito, F., Santoro, C., Leonetti Crescenzi, S., Porrini, R., Di Giandomenico, J., Villivà, N., Spadea, A., Rago, A., De Gregoris, C., Romano, A., Anaclerico, B., De Muro, M., Felici, S., Breccia, M., Montefusco, E., ... Gruppo Laziale, SMPC Ph1 (2017). High platelet count at diagnosis is a protective factor for thrombosis in patients with essential thrombocythemia. Thrombosis Research, 156, 168-171. https://doi.org/10.1016/j.thromres.2017.06.023