Thrombotic Complications and Risk of Myeloid Transformation in 164 Elderly Patients with Essential Thrombocythemia.
Notice bibliographique
Résumé
Abstract Abstract 2916 Poster Board II-892 Introduction: Essential thrombocythemia (ET) is a myeloproliferative neoplasm associated with increased risk of both venous and arterial thrombosis, hemorrhage and transformation to other myeloid disorders such as myelofibrosis (MF), myelodysplastic syndrome (MDS), and acute myeloid leukemia (AML). Although age greater than 60 years has been shown to be an independent risk factor for thrombosis, data regarding disease outcome and optimal therapy in the very elderly diagnosed with ET is limited. Our aim was to assess rates of thrombo-hemorrhagic complications and transformation in very elderly patients with ET at two tertiary care centers in Vancouver, British Columbia. Patients and methods: A retrospective chart review was conducted of all patients diagnosed with ET at age 60 years or older from 1982 to 2008. Data collected included baseline patient characteristics, arterial and venous thrombosis at diagnosis, cardiac risk factors, antiplatelet and cytoreductive therapy throughout the course of the disease, and thrombo-hemorrhagic complications or transformation to AML, MDS or MF during the follow-up period. The patients were separated into three age groups: 60 to 69 years, 70 to 79 years, and 80+ years. Chi-squared tests were used to compare the age groups in terms of baseline characteristics, treatment, thrombotic and hemorrhagic complications, and myeloid transformation. Kaplan-Meier curves for thrombosis and transformation-free survival were generated to follow rates of thrombosis and transformation over time. Results: We identified 164 patients diagnosed with ET at age 60 years or older, of which 68 were 60-69 years, 66 were 70-79 years and 30 patients were 80+ years. The median duration of follow-up was 2576 days for the 60-69 group, 1903 days for the 70-79 group, and 453 days for the 80+ group. The three groups were similar in baseline characteristics, including cardiac risk factors, baseline levels of haemoglobin, white blood cells and platelets, as well as the rates of thrombotic or hemorrhagic events at diagnosis. Treatment including the use of ASA (91% 60-69y, 80.3% 70-79y and 75.9% 80+y, p=0.10) and hydroxyurea therapy (67.2% 60-69y, 80.3% 70-79y and 73.3% 80+y, p=0.23) was comparable amongst the three age groups. The number of patients developing thrombotic events during follow up (30.9% 60-69y, 16.7% 70-79y and 13.3% 80+y, p=0.063) and the risk of thrombosis over time (Figure 1A) was similar across the three age groups (p=0.68). The number of patients with myeloid transformation during follow up was greater in the 60-69 age group (25% 60-69y, 9.1% 70-79y and 6.7% 80+y, p=0.013), but the risk of transformation over time was not significantly different (p=0.29) (Figure 1B). Conclusions: Age over 60 years has previously been shown to be a risk factor for thrombosis in patients with ET. The current study found no differences in the rates of thrombotic complications, nor myeloid transformation amongst three subgroups of elderly patients with ET. We also note that physicians' treatment approach does not seem to differ amongst these elderly subgroups. Although our data is limited by a small number of very elderly patients, we conclude that the disease course is not different amongst various age groups of elderly patients with ET. With currently available information, there is no reason to consider the disease differently in such patients. Disclosures: No relevant conflicts of interest to declare.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».