Leucocytosis in polycythaemia vera predicts both inferior survival and leukaemic transformation
Open Access
- 3 July 2007
- journal article
- Published by Wiley in British Journal of Haematology
- Vol. 138 (3), 354-358
- https://doi.org/10.1111/j.1365-2141.2007.06674.x
Abstract
Leucocytosis (leucocyte count >15 × 109/l) was recently associated with thrombosis in polycythaemia vera (PV). This study sought the prognostic relevance of leucocytosis for survival and leukaemic or fibrotic transformation. Amongst 459 patients with PV seen at our institution in recent years (median age, 60 years; 56% males), 146 deaths and 88 leukaemic (n = 34) or fibrotic (n = 54) transformations were documented. Arterial or venous thrombosis occurred in 14% and 9% of patients at diagnosis and in 25% and 15% during follow-up, respectively. Multivariate analysis identified the advanced age (P < 0·0001), leucocytosis (leucocyte count ≥15 × 109/l; P = 0·0006) and arterial thrombosis at diagnosis (P = 0·01) as independent predictors of inferior survival. In the absence of the first two risk factors, median survival was projected at 272 months as opposed to 108 months in the presence of both risk factors (P < 0·0001). Leucocytosis was also identified as an independent predictor of both leukaemic transformation and venous thrombosis during follow-up. Time-to-event analysis did not disclose a significant association between single or multiple cytotoxic drug exposure and either leukaemic or fibrotic transformation. The current study highlighted the prognostic relevance of leucocytosis on various aspects of the disease in PV.Keywords
This publication has 30 references indexed in Scilit:
- The interaction between leukocytosis and other risk factors for thrombosis in essential thrombocythemiaBlood, 2007
- JAK2Exon 12 Mutations in Polycythemia Vera and Idiopathic ErythrocytosisNew England Journal of Medicine, 2007
- The haematocrit and platelet target in polycythemia veraBritish Journal of Haematology, 2006
- Evidence-based management of polycythemia veraBest Practice & Research Clinical Haematology, 2006
- JAK2V617F mutation in platelets from essential thrombocythemia patients: correlation with clinical features and analysis of STAT5 phosphorylation statusEuropean Journal of Haematology, 2006
- Estrogen-based hormone therapy and thrombosis risk in women with essential thrombocythemiaCancer, 2006
- The presence of the JAK2 V617F mutation is associated with a higher haemoglobin and increased risk of thrombosis in essential thrombocythaemiaBritish Journal of Haematology, 2005
- A Gain-of-Function Mutation ofJAK2in Myeloproliferative DisordersNew England Journal of Medicine, 2005
- A unique clonal JAK2 mutation leading to constitutive signalling causes polycythaemia veraNature, 2005
- Long-term outcomes of polycythemia vera patients treated with pipobroman as initial therapyThe Hematology Journal, 2003