Leukocytosis as a major thrombotic risk factor in patients with polycythemia vera.

In polycythemia vera, vascular risk assessment is based on age and thrombotic history, while the role of other potential predictors of this risk is still uncertain. Thus, we exploited the large database collected by the observational study of the European Collaboration on Low-Dose Aspirin in Polycythemia Vera (ECLAP) to investigate the association of hematologic variables and cardiovascular risk factors with the thrombotic risk. Among 1638 polycythemic patients followed for 2.7 +/- 1.3 years, there were 205 thromboses. Subjects with hypertension had a mild nonsignificant increase in the risk of arterial thrombosis, while this risk was significantly increased by smoking (hazard ratio [HR], 1.90; 95% confidence interval [CI], 1.15-3.14; P = .012). The time-dependent analysis adjusted for potential confounders showed that patients with a white blood cell count above 15 x 10(9)/L, compared with those with a white blood cell count below 10 x 10(9)/L, had a significant increase in the risk of thrombosis (HR, 1.71; 95% CI, 1.10-2.65; P = .017), mainly deriving from an increased risk of myocardial infarction (HR, 2.84; 95% CI, 1.25-6.46; P = .013). Thus, leukocyte count may help in defining the vascular risk of polycythemic subjects.
AuthorsRaffaele Landolfi, Leonardo Di Gennaro, Tiziano Barbui, Valerio De Stefano, Guido Finazzi, Rosamaria Marfisi, Gianni Tognoni, Roberto Marchioli,
JournalBlood (Blood) Vol. 109 Issue 6 Pg. 2446-52 (Mar 15 2007) ISSN: 0006-4971 [Print] United States
PMID17105814 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Aspirin
  • Aged
  • Aspirin (therapeutic use)
  • Female
  • Follow-Up Studies
  • Humans
  • Leukocyte Count
  • Leukocytosis (complications, epidemiology, pathology)
  • Male
  • Middle Aged
  • Polycythemia Vera (complications, drug therapy, epidemiology, pathology)
  • Risk Factors
  • Thrombosis (epidemiology, etiology, pathology)

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