Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms

Luigi Gugliotta; Alessandra Iurlo; Gabriele Gugliotta; Alessia Tieghi; Giorgina Specchia; Gianluca Gaidano; Potito R. Scalzulli; Elisa Rumi; Alfredo Dragani; Vincenzo Martinelli; Cristina Santoro; Maria Luigia Randi; Giuseppe Tagariello; Anna Candoni; Daniele Cattaneo; Alessandra Ricco; Raffaele Palmieri; Marina A. Liberati; Maria Langella; Angela Rago; Micaela Bergamaschi; Paola Monari; Rossella Miglio; Umberto Santoro; Rossella Cacciola; Serena Rupoli; Lucia Mastrullo; Pellegrino Musto; Maria Gabriella Mazzucconi; Marco Vignetti; Agostino Cortelezzi; Nicola Vianelli; Bruno Martino; Valerio De Stefano; Francesco Passamonti; Alessandro M. Vannucchi

doi:10.1016/j.leukres.2016.04.004

Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms

Luigi Gugliotta
, Alessandra Iurlo
, Gabriele Gugliotta
, Alessia Tieghi
, Giorgina Specchia
, Gianluca Gaidano
, Potito R. Scalzulli
, Elisa Rumi
, Alfredo Dragani
, Vincenzo Martinelli
, Cristina Santoro
, Maria Luigia Randi
, Giuseppe Tagariello
, Anna Candoni
, Daniele Cattaneo
, Alessandra Ricco
, Raffaele Palmieri
, Marina A. Liberati
, Maria Langella
, Angela Rago

Micaela Bergamaschi, Paola Monari, Rossella Miglio, Umberto Santoro, Rossella Cacciola, Serena Rupoli, Lucia Mastrullo, Pellegrino Musto, Maria Gabriella Mazzucconi, Marco Vignetti, Agostino Cortelezzi, Nicola Vianelli, Bruno Martino, Valerio De Stefano, Francesco Passamonti, Alessandro M. Vannucchi

Alma Mater Studiorum University of Bologna
IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia
Giovanni XXIII Hospital
University of Eastern Piedmont
IRCCS Ospedale Casa Sollievo della Sofferenza - San Giovanni Rotondo (FG)
IRCCS Fondazione Policlinico San Matteo - Pavia
Ospedale S. Spirito
University of Naples Federico II
University of Rome La Sapienza
Azienda Ospedaliera di Padova
S. Giacomo Apostolo Hospital
S. Maria Della Misericordia Hospital
Azienda Ospedaliera S.G. Moscati
Azienda Ospedaliera S. Maria di Terni
Ospedale Civile Di Vicenza
Santa Maria Goretti Hospital
San Martino Hospital Genoa
University of Bologna
IRCCS Istituto Ortopedico Rizzoli - Bologna
University of Catania
Marche Polytechnic University
Hemophilia and Thrombosis Centre
IRCCS Centro di riferimento oncologico della Basilicata - Rionero in Vulture (PZ)
Azienda Ospedaliera Bianchi-Melacrino-Morelli
Ospedale di Circolo
University Hospital of Florence

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

In patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), the anti-thrombotic and/or cytoreductive treatment in the follow-up may affect the evaluation of the pro-thrombotic weight of the clinical and biological characteristics at diagnosis. In order to avoid this potential confounding effect, we investigated the relationship between prior thrombosis (PrTh: thrombosis occurred before diagnosis and before treatment) and the characteristics at diagnosis in 977 thrombocythemic patients with MPN, reclassified according to the WHO 2008 criteria. PrTh occurred in 194 (19.9%) patients, with similar rates in the different MPNs. In multivariate analysis, PrTh rate was significantly related to minor thrombocytosis (platelets ≤700 × 109/L), leukocytosis (leukocytes >10 × 109/L), higher hematocrit (HCT >45%), JAK2 V617F mutation, older age, and cardiovascular risk factors (CVRFs). The highest PrTh rate (33.9%) was associated with the coexistence of minor thrombocytosis and leukocytosis. Of note, the inverse relationship between PrTh rate and platelet count is consistent with the hemostatic paradox of thrombocytosis. In conclusion, this analysis in MPN patients disclosed the unbiased characteristics at diagnosis with a pro-thrombotic effect. Moreover, it suggests that the optimal control of blood cells counts, and CVRFs might be of utmost importance in the prevention of thrombosis during the follow-up.

Original language	English
Pages (from-to)	18-25
Number of pages	8
Journal	Leukemia Research
Volume	46
DOIs	https://doi.org/10.1016/j.leukres.2016.04.004
Publication status	Published - 2016

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Cancer Research
Hematocrit
Hematology
JAK2
Leukocytes
Oncology
Platelets
Thrombocythemia
Thrombosis

Access to Document

10.1016/j.leukres.2016.04.004

Cite this

Gugliotta, L., Iurlo, A., Gugliotta, G., Tieghi, A., Specchia, G., Gaidano, G., Scalzulli, P. R., Rumi, E., Dragani, A., Martinelli, V., Santoro, C., Randi, M. L., Tagariello, G., Candoni, A., Cattaneo, D., Ricco, A., Palmieri, R., Liberati, M. A., Langella, M., ... Vannucchi, A. M. (2016). Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms. Leukemia Research, 46, 18-25. https://doi.org/10.1016/j.leukres.2016.04.004

@article{0c9fa20b78634c4aaa170e1ddb0cd89e,

title = "Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms",

abstract = "In patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), the anti-thrombotic and/or cytoreductive treatment in the follow-up may affect the evaluation of the pro-thrombotic weight of the clinical and biological characteristics at diagnosis. In order to avoid this potential confounding effect, we investigated the relationship between prior thrombosis (PrTh: thrombosis occurred before diagnosis and before treatment) and the characteristics at diagnosis in 977 thrombocythemic patients with MPN, reclassified according to the WHO 2008 criteria. PrTh occurred in 194 (19.9\%) patients, with similar rates in the different MPNs. In multivariate analysis, PrTh rate was significantly related to minor thrombocytosis (platelets ≤700 × 109/L), leukocytosis (leukocytes >10 × 109/L), higher hematocrit (HCT >45\%), JAK2 V617F mutation, older age, and cardiovascular risk factors (CVRFs). The highest PrTh rate (33.9\%) was associated with the coexistence of minor thrombocytosis and leukocytosis. Of note, the inverse relationship between PrTh rate and platelet count is consistent with the hemostatic paradox of thrombocytosis. In conclusion, this analysis in MPN patients disclosed the unbiased characteristics at diagnosis with a pro-thrombotic effect. Moreover, it suggests that the optimal control of blood cells counts, and CVRFs might be of utmost importance in the prevention of thrombosis during the follow-up.",

keywords = "Cancer Research, Hematocrit, Hematology, JAK2, Leukocytes, Oncology, Platelets, Thrombocythemia, Thrombosis, Cancer Research, Hematocrit, Hematology, JAK2, Leukocytes, Oncology, Platelets, Thrombocythemia, Thrombosis",

author = "Luigi Gugliotta and Alessandra Iurlo and Gabriele Gugliotta and Alessia Tieghi and Giorgina Specchia and Gianluca Gaidano and Scalzulli, \{Potito R.\} and Elisa Rumi and Alfredo Dragani and Vincenzo Martinelli and Cristina Santoro and Randi, \{Maria Luigia\} and Giuseppe Tagariello and Anna Candoni and Daniele Cattaneo and Alessandra Ricco and Raffaele Palmieri and Liberati, \{Marina A.\} and Maria Langella and Angela Rago and Micaela Bergamaschi and Paola Monari and Rossella Miglio and Umberto Santoro and Rossella Cacciola and Serena Rupoli and Lucia Mastrullo and Pellegrino Musto and Mazzucconi, \{Maria Gabriella\} and Marco Vignetti and Agostino Cortelezzi and Nicola Vianelli and Bruno Martino and \{De Stefano\}, Valerio and Francesco Passamonti and Vannucchi, \{Alessandro M.\}",

year = "2016",

doi = "10.1016/j.leukres.2016.04.004",

language = "English",

volume = "46",

pages = "18--25",

journal = "Leukemia Research",

issn = "0145-2126",

publisher = "Elsevier Ltd",

}

Gugliotta, L, Iurlo, A, Gugliotta, G, Tieghi, A, Specchia, G, Gaidano, G, Scalzulli, PR, Rumi, E, Dragani, A, Martinelli, V, Santoro, C, Randi, ML, Tagariello, G, Candoni, A, Cattaneo, D, Ricco, A, Palmieri, R, Liberati, MA, Langella, M, Rago, A, Bergamaschi, M, Monari, P, Miglio, R, Santoro, U, Cacciola, R, Rupoli, S, Mastrullo, L, Musto, P, Mazzucconi, MG, Vignetti, M, Cortelezzi, A, Vianelli, N, Martino, B, De Stefano, V, Passamonti, F & Vannucchi, AM 2016, 'Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms', Leukemia Research, vol. 46, pp. 18-25. https://doi.org/10.1016/j.leukres.2016.04.004

TY - JOUR

T1 - Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms

AU - Gugliotta, Luigi

AU - Iurlo, Alessandra

AU - Gugliotta, Gabriele

AU - Tieghi, Alessia

AU - Specchia, Giorgina

AU - Gaidano, Gianluca

AU - Scalzulli, Potito R.

AU - Rumi, Elisa

AU - Dragani, Alfredo

AU - Martinelli, Vincenzo

AU - Santoro, Cristina

AU - Randi, Maria Luigia

AU - Tagariello, Giuseppe

AU - Candoni, Anna

AU - Cattaneo, Daniele

AU - Ricco, Alessandra

AU - Palmieri, Raffaele

AU - Liberati, Marina A.

AU - Langella, Maria

AU - Rago, Angela

AU - Bergamaschi, Micaela

AU - Monari, Paola

AU - Miglio, Rossella

AU - Santoro, Umberto

AU - Cacciola, Rossella

AU - Rupoli, Serena

AU - Mastrullo, Lucia

AU - Musto, Pellegrino

AU - Mazzucconi, Maria Gabriella

AU - Vignetti, Marco

AU - Cortelezzi, Agostino

AU - Vianelli, Nicola

AU - Martino, Bruno

AU - De Stefano, Valerio

AU - Passamonti, Francesco

AU - Vannucchi, Alessandro M.

PY - 2016

Y1 - 2016

N2 - In patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), the anti-thrombotic and/or cytoreductive treatment in the follow-up may affect the evaluation of the pro-thrombotic weight of the clinical and biological characteristics at diagnosis. In order to avoid this potential confounding effect, we investigated the relationship between prior thrombosis (PrTh: thrombosis occurred before diagnosis and before treatment) and the characteristics at diagnosis in 977 thrombocythemic patients with MPN, reclassified according to the WHO 2008 criteria. PrTh occurred in 194 (19.9%) patients, with similar rates in the different MPNs. In multivariate analysis, PrTh rate was significantly related to minor thrombocytosis (platelets ≤700 × 109/L), leukocytosis (leukocytes >10 × 109/L), higher hematocrit (HCT >45%), JAK2 V617F mutation, older age, and cardiovascular risk factors (CVRFs). The highest PrTh rate (33.9%) was associated with the coexistence of minor thrombocytosis and leukocytosis. Of note, the inverse relationship between PrTh rate and platelet count is consistent with the hemostatic paradox of thrombocytosis. In conclusion, this analysis in MPN patients disclosed the unbiased characteristics at diagnosis with a pro-thrombotic effect. Moreover, it suggests that the optimal control of blood cells counts, and CVRFs might be of utmost importance in the prevention of thrombosis during the follow-up.

AB - In patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), the anti-thrombotic and/or cytoreductive treatment in the follow-up may affect the evaluation of the pro-thrombotic weight of the clinical and biological characteristics at diagnosis. In order to avoid this potential confounding effect, we investigated the relationship between prior thrombosis (PrTh: thrombosis occurred before diagnosis and before treatment) and the characteristics at diagnosis in 977 thrombocythemic patients with MPN, reclassified according to the WHO 2008 criteria. PrTh occurred in 194 (19.9%) patients, with similar rates in the different MPNs. In multivariate analysis, PrTh rate was significantly related to minor thrombocytosis (platelets ≤700 × 109/L), leukocytosis (leukocytes >10 × 109/L), higher hematocrit (HCT >45%), JAK2 V617F mutation, older age, and cardiovascular risk factors (CVRFs). The highest PrTh rate (33.9%) was associated with the coexistence of minor thrombocytosis and leukocytosis. Of note, the inverse relationship between PrTh rate and platelet count is consistent with the hemostatic paradox of thrombocytosis. In conclusion, this analysis in MPN patients disclosed the unbiased characteristics at diagnosis with a pro-thrombotic effect. Moreover, it suggests that the optimal control of blood cells counts, and CVRFs might be of utmost importance in the prevention of thrombosis during the follow-up.

KW - Cancer Research

KW - Hematocrit

KW - Hematology

KW - JAK2

KW - Leukocytes

KW - Oncology

KW - Platelets

KW - Thrombocythemia

KW - Thrombosis

KW - Cancer Research

KW - Hematocrit

KW - Hematology

KW - JAK2

KW - Leukocytes

KW - Oncology

KW - Platelets

KW - Thrombocythemia

KW - Thrombosis

UR - http://hdl.handle.net/10807/93257

UR - http://www.elsevier.com/locate/leukres

U2 - 10.1016/j.leukres.2016.04.004

DO - 10.1016/j.leukres.2016.04.004

M3 - Article

SN - 0145-2126

VL - 46

SP - 18

EP - 25

JO - Leukemia Research

JF - Leukemia Research

ER -

Unbiased pro-thrombotic features at diagnosis in 977 thrombocythemic patients with Philadelphia-negative chronic myeloproliferative neoplasms

Abstract

UN SDGs

Keywords

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