Risk factors for arterial and venous thrombosis in WHO-defined essential thrombocythemia: an international study of 891 patients

Blood. 2011 Jun 2;117(22):5857-9. doi: 10.1182/blood-2011-02-339002. Epub 2011 Apr 13.

Abstract

In an international collaborative study, a central histologic review identified 891 patients with essential thrombocythemia, strictly defined by World Health Organization criteria. After a median follow-up of 6.2 years, 109 (12%) patients experienced arterial (n = 79) or venous (n = 37) thrombosis. In multivariable analysis, predictors of arterial thrombosis included age more than 60 years (P = .03; hazard ratio [HR] = 1.7), thrombosis history (P = .003; HR = 2.1), cardiovascular risk factors including tobacco use, hypertension, or diabetes mellitus (P = .007; HR = 1.9), leukocytosis (> 11 × 10(9)/L; P = .04; HR = 1.7), and presence of JAK2V617F (P = .009; HR = 2.6). In contrast, only male gender predicted venous thrombosis. Platelet count more than 1000 × 10(9)/L was associated with a lower risk of arterial thrombosis (P = .007; HR = 0.4). These associations, except the one with leukocytosis, remained significant (or near significant) when analysis was restricted to JAK2V617F-positive cases. The current study clarifies the contribution of specific disease and host characteristics to the risk of arterial versus venous thrombosis in essential thrombocythemia.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arteries / pathology*
  • Cardiovascular Diseases / complications
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / complications
  • Incidence
  • International Agencies
  • Janus Kinase 2 / genetics
  • Male
  • Middle Aged
  • Mutation / genetics
  • Polycythemia Vera / complications
  • Prognosis
  • Risk Factors
  • Survival Rate
  • Thrombocythemia, Essential / complications*
  • Thrombocythemia, Essential / therapy
  • Thrombosis / etiology*
  • Thrombosis / pathology
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / pathology

Substances

  • JAK2 protein, human
  • Janus Kinase 2