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Decisional flow with a scoring system to start platelet-lowering treatment in patients with essential thrombocythemia: long-term results.
- Source :
-
International journal of hematology [Int J Hematol] 2009 Nov; Vol. 90 (4), pp. 486-491. Date of Electronic Publication: 2009 Aug 22. - Publication Year :
- 2009
-
Abstract
- We prospectively tested, at diagnosis in essential thrombocythemia (ET) patients with no clear indication to platelet (PLT)-lowering treatment, a scoring system based on age, PLT level, cardiovascular diseases, previous thrombotic events, smoking and dysmetabolic diseases. From 04/92 to 03/98, 168 consecutive patients were enrolled. Hydroxyurea (HU) was started at diagnosis in 32 "symptomatic" patients and in 33 patients aged >70 years. The remaining 103 patients ("asymptomatic" and aged <70 years) were classified according to our scoring system. Thirty-two patients with score > or = 4 started HU early after diagnosis. The remaining 71 patients with score <4 at diagnosis received anti-aggregating agents only; of them, 24 (33.8%) started HU during follow-up after a median time from diagnosis of 28 months, while 47 (66.2%) did not start any PLT-lowering treatment. Thrombotic complications occurred in 9/103 patients (8.7%); in particular, they occurred in 4/32 patients (12.5%) with score > or = 4 receiving HU since diagnosis and in 5/71 (7%) with score <4 under anti-aggregating agents only. This scoring system appears effective to discriminate a different risk of thrombotic events, and could be useful to decide when a PLT-lowering therapy needs to be started.
- Subjects :
- Adult
Aged
Aged, 80 and over
Aging
Cardiovascular Diseases complications
Clinical Protocols
Female
Follow-Up Studies
Humans
Male
Metabolic Diseases complications
Middle Aged
Platelet Count
Risk Factors
Smoking
Survival Analysis
Thrombocythemia, Essential blood
Thrombocythemia, Essential classification
Thrombocythemia, Essential complications
Thrombosis complications
Thrombosis prevention & control
Treatment Outcome
Blood Platelets drug effects
Hydroxyurea therapeutic use
Platelet Aggregation Inhibitors therapeutic use
Thrombocythemia, Essential drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1865-3774
- Volume :
- 90
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- International journal of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 19701677
- Full Text :
- https://doi.org/10.1007/s12185-009-0401-7