Development and validation of an International Prognostic Score of thrombosis in World Health Organization-essential thrombocythemia (IPSET-thrombosis)

Valerio De Stefano, Silvia Betti, T Barbui, G Finazzi, A Carobbio, J Thiele, F Passamonti, E Rumi, M Ruggeri, F Rodeghiero, M Randi, I Bertozzi, H Gisslinger, V Buxhofer Ausch, A Rambaldi, A Vannucchi, A. Tefferi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

303 Citazioni (Scopus)

Abstract

Accurate prediction of thrombosis in essential thrombocythemia (ET) provides the platform for prospective studies exploring preventive measures. Current risk stratification for thrombosis in ET is 2-tiered and considers low-and high-risk categories based on the respective absence or presence of either age > 60 years or history of thrombosis. In an international study of 891 patients with World Health Organization (WHO)-defined ET, we identified additional independent risk factors including cardiovascular risk factors and JAK2V617F. Accordingly, we assigned risk scores based on multivariable analysis-derived hazard ratios (HRs) to age > 60 years (HR = 1.5; 1 point), thrombosis history (HR = 1.9; 2 points), cardiovascular risk factors (HR = 1.6; 1 point), and JAK2V617F (HR = 2.0; 2 points) and subsequently devised a 3-tiered prognostic model (low-risk = < 2 points; intermediate-risk = 2 points; and high-risk = > 2 points) using a training set of 535 patients and validated the results in the remaining cohort (n = 356; internal validation set) and in an external validation set (n = 329). Considering all 3 cohorts (n = 1220), the 3-tiered new prognostic model (low-risk n = 474 vs intermediate-risk n = 471 vs high-risk n = 275), with a respective thrombosis risk of 1.03% of patients/y versus 2.35% of patients/y versus 3.56% of patients/y, outperformed the 2-tiered (low-risk 0.95% of patients/y vs high-risk 2.86% of patients/y) conventional risk stratification in predicting future vascular events. (Blood. 2012; 120(26): 5128-5133)
Lingua originaleEnglish
pagine (da-a)5128-5133
Numero di pagine6
RivistaBlood
Volume120
DOI
Stato di pubblicazionePubblicato - 2012

Keywords

  • Essential thrombocythemia

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