5 results on '"Casares M"'
Search Results
2. Natural history of polycythemia vera and essential thrombocythemia presenting with splanchnic vein thrombosis.
- Author
-
Alvarez-Larrán A, Pereira A, Magaz M, Hernández-Boluda JC, Garrote M, Cuevas B, Ferrer-Marín F, Gómez-Casares MT, García-Gutiérrez V, Mata-Vázquez MI, Turon F, Hernandez-Gea V, Arellano-Rodrigo E, Cervantes F, and García-Pagán JC
- Subjects
- Adult, Disease Progression, Female, Follow-Up Studies, Hemorrhage epidemiology, Humans, Kaplan-Meier Estimate, Liver Diseases epidemiology, Male, Mesenteric Veins, Middle Aged, Neoplasms, Second Primary epidemiology, Portal Vein, Primary Myelofibrosis etiology, Proportional Hazards Models, Registries, Risk, Spain epidemiology, Splenic Vein, Polycythemia Vera complications, Splanchnic Circulation, Thrombocythemia, Essential complications, Venous Thrombosis etiology
- Abstract
Patients with polycythemia vera (PV) or essential thrombocythemia (ET) presenting with splanchnic vein thrombosis (SVT) might have a specific clinico-biological profile. To investigate this hypothesis, 3705 PV/ET patients from three national registers, 118 of them presenting with SVT, were reviewed. After correction for age and sex, PV/ET patients with SVT showed an increased risk of death (HR 2.47, 95% CI 1.5-4.01, p < 0.001), venous thrombosis (IRR 3.4, 95%CI 2.1-5.5, p < 0.001), major bleeding (IRR 3.6, 95%CI 2.3-5.5, p < 0.001), and second cancer (IRR 2.37, 95%CI 1.4-4.1, p = 0.002). No case of acute leukemia was documented among patients with PV/ET presenting with SVT and seven of them (6%) progressed to myelofibrosis. SVT was not associated with lower risk of MF after correction by age and sex. Patients with SVT more frequently died from complications related to hepatic disease, major bleeding, or second cancer, resulting in a 5-year reduction of age- and sex-adjusted median survival. In conclusion, PV and ET patients presenting with SVT have shorter survival than patients with PV and ET of the same age and sex. This excess mortality is related to liver disease, major bleeding, and second cancer rather than to the natural evolution of the MPN.
- Published
- 2020
- Full Text
- View/download PDF
3. Performance of the myelofibrosis secondary to PV and ET-prognostic model (MYSEC-PM) in a series of 262 patients from the Spanish registry of myelofibrosis.
- Author
-
Hernández-Boluda JC, Pereira A, Correa JG, Alvarez-Larrán A, Ferrer-Marín F, Raya JM, Martínez-López J, Pérez-Encinas M, Estrada N, Velez P, Fox ML, García-Gutiérrez V, Payer A, Kerguelen A, Cuevas B, Durán MA, Ramírez MJ, Gómez-Casares MT, Mata-Vázquez MI, Mora E, Martínez-Valverde C, Gómez M, and Cervantes F
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prognosis, Registries, Polycythemia Vera pathology, Primary Myelofibrosis pathology, Thrombocythemia, Essential pathology
- Published
- 2018
- Full Text
- View/download PDF
4. Frequency and prognostic value of resistance/intolerance to hydroxycarbamide in 890 patients with polycythaemia vera.
- Author
-
Alvarez-Larrán A, Kerguelen A, Hernández-Boluda JC, Pérez-Encinas M, Ferrer-Marín F, Bárez A, Martínez-López J, Cuevas B, Mata MI, García-Gutiérrez V, Aragües P, Montesdeoca S, Burgaleta C, Caballero G, Hernández-Rivas JA, Durán MA, Gómez-Casares MT, and Besses C
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Drug Resistance, Drug Tolerance, Female, Humans, Hydroxyurea adverse effects, Kaplan-Meier Estimate, Leukocyte Count, Leukopenia chemically induced, Male, Middle Aged, Nucleic Acid Synthesis Inhibitors adverse effects, Polycythemia Vera blood, Prognosis, Registries, Retrospective Studies, Treatment Outcome, Young Adult, Hydroxyurea therapeutic use, Nucleic Acid Synthesis Inhibitors therapeutic use, Polycythemia Vera drug therapy
- Abstract
The clinical significance of resistance/intolerance to hydroxycarbamide (HC) was assessed in a series of 890 patients with polycythaemia vera (PV). Resistance/intolerance to HC was recorded in 137 patients (15·4%), consisting of: need for phlebotomies (3·3%), uncontrolled myeloproliferation (1·6%), failure to reduce massive splenomegaly (0·8%), development of cytopenia at the lowest dose of HC to achieve a response (1·7%) and extra-haematological toxicity (9%). With a median follow-up of 4·6 years, 99 patients died, resulting in a median survival of 19 years. Fulfilling any of the resistance/intolerance criteria had no impact on survival but when the different criteria were individually assessed, an increased risk of death was observed in patients developing cytopenia [Hazard ratio (HR): 3·5, 95% confidence interval (CI): 1·5-8·3, P = 0·003]. Resistance/intolerance had no impact in the rate of thrombosis or bleeding. Risk of myelofibrotic transformation was significantly higher in those patients developing cytopenia (HR: 5·1, 95% CI: 1·9-13·7, P = 0·001) and massive splenomegaly (HR: 9·1, 95% CI: 2·3-35·9, P = 0·002). Cytopenia at the lowest dose required to achieve a response was also an independent risk factor for transformation to acute leukaemia (HR: 20·3, 95% CI: 5·4-76·5, P < 0·001). In conclusion, the unified definition of resistance/intolerance to HC delineates a heterogeneous group of PV patients, with those developing cytopenia being associated with an adverse outcome., (© 2015 John Wiley & Sons Ltd.)
- Published
- 2016
- Full Text
- View/download PDF
5. Busulfan in patients with polycythemia vera or essential thrombocythemia refractory or intolerant to hydroxyurea.
- Author
-
Alvarez-Larrán A, Martínez-Avilés L, Hernández-Boluda JC, Ferrer-Marín F, Antelo ML, Burgaleta C, Mata MI, Xicoy B, Martínez-Trillos A, Gómez-Casares MT, Durán MA, Marcote B, Ancochea A, Senín A, Angona A, Gómez M, Vicente V, Cervantes F, Bellosillo B, and Besses C
- Subjects
- Aged, Aged, 80 and over, Blood Cell Count, Comorbidity, Disease Progression, Drug Resistance, Drug Substitution, Female, Hematocrit, Hemorrhage etiology, Humans, Hydroxyurea adverse effects, Hydroxyurea therapeutic use, Janus Kinase 2 genetics, Kaplan-Meier Estimate, Leukemia, Myeloid, Acute epidemiology, Leukemia, Myeloid, Acute etiology, Male, Middle Aged, Polycythemia Vera complications, Polycythemia Vera genetics, Remission Induction, Risk Factors, Thrombocythemia, Essential complications, Thrombocythemia, Essential genetics, Thrombosis etiology, Treatment Outcome, Alkylating Agents therapeutic use, Busulfan therapeutic use, Polycythemia Vera drug therapy, Thrombocythemia, Essential drug therapy
- Abstract
Therapeutic options for patients with polycythemia vera (PV) and essential thrombocythemia (ET) resistant or intolerant to hydroxyurea are limited. Busulfan is effective as first-line therapy, but there is scarce information on this drug as second-line treatment. The efficacy of busulfan in patients with advanced PV or ET refractory or intolerant to hydroxyurea was assessed in 36 patients (PV n = 15, ET n = 21) treated for a median of 256 days. Complete hematological response (CHR) was achieved in 83 % of patients, after a median time of 203 days (range 92-313). The probability of sustained CHR at 1 and 2 years was 87 and 62 %, respectively. Time to CHR was shorter in patients treated with ≥14 mg of busulfan per week than with lower doses (141 versus 336 days, p = 0.01). Partial molecular response was achieved in three out of nine (33 %) patients. Busulfan was stopped in 27 patients (75 %) due to CHR achievement in 18 cases (67 %), hematological toxicity in 8 cases (30 %), and disease transformation in 1 case. With a median follow-up of 721 days, six patients have died, with the probability of survival at 2 years being 85 %. The probability of thrombosis at 2 years was 11 %. Transformation into acute leukemia or myelodysplastic syndrome was observed in three cases, all of them in a JAK2V617F-negative clone carrying additional mutations. Busulfan, at a dose of 2 mg/day, is an effective option for elderly patients with PV or ET who fail to hydroxyurea, but a significant rate of transformation was observed.
- Published
- 2014
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.