Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera

Hematological control, incidence of complications, and need for cytoreduction were studied in 453 patients with low-risk polycythemia vera (PV) treated with phlebotomies alone. Median hematocrit value decreased from 54% at diagnosis to 45% at 12 months, and adequate hematocrit control over time (<...

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Autores: Triguero, A, Pedraza, A, Perez-Encinas, M, Mata-Vazquez, MI, Velez, P, Fox, L, Gomez-Calafat, M, Garcia-Delgado, R, Gasior, M, Ferrer-Marin, F, Garcia-Gutierrez, V, Angona, A, Gomez-Casares, MT, Cuevas, B, Martinez, C, Perez, R, Raya, JM, Guerrero, L, Murillo, I, Bellosillo, B, Hernandez-Boluda, JC, Sanz, C, Alvarez-Larran, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p12239
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12239
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137306096&doi=10.1007%2fs00277-022-04963-z&partnerID=40&md5=3ddc7b53703f3c2298a6a25268b0c945
Access Level:acceso abierto
Palabra clave:Polycythemia vera
Low-risk
Phlebotomies
Thrombosis
Myelofibrosis
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spelling Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia VeraTriguero, APedraza, APerez-Encinas, MMata-Vazquez, MIVelez, PFox, LGomez-Calafat, MGarcia-Delgado, RGasior, MFerrer-Marin, FGarcia-Gutierrez, VAngona, AGomez-Casares, MTCuevas, BMartinez, CPerez, RRaya, JMGuerrero, LMurillo, IBellosillo, BHernandez-Boluda, JCSanz, CAlvarez-Larran, APolycythemia veraLow-riskPhlebotomiesThrombosisMyelofibrosisHematological control, incidence of complications, and need for cytoreduction were studied in 453 patients with low-risk polycythemia vera (PV) treated with phlebotomies alone. Median hematocrit value decreased from 54% at diagnosis to 45% at 12 months, and adequate hematocrit control over time (<45%) was observed in 36%, 44%, and 32% of the patients at 6, 12, and 24 months, respectively. More than 5 phlebotomies per year in the maintenance phase were required in 19% of patients. Worsening thrombocytosis, age > 60 years, and microvascular symptoms constituted the main indications for starting cytoreduction. Median duration without initiating cytoreduction was significantly longer in patients younger than 50 years (< 0.0001). The incidence rate of thrombosis under phlebotomies alone was 0.8% per year and the estimated probability of thrombosis at 10 years was 8.5%. The probability of arterial thrombosis was significantly higher in patients with arterial hypertension whereas there was a trend to higher risk of venous thrombosis in cases with high JAK2V617F allele burden. Rates of major bleeding and second primary neoplasm were low. With a median follow-up of 9 years, survival probability at 10 years was 97%, whereas the probability of myelofibrosis at 10 and 20 years was 7% and 20%, respectively. Progression to acute myeloid leukemia was documented in 3 cases (1%). Current management of low-risk PV patients is associated with low rate of thrombosis and long survival. New treatment strategies are needed for improving hematological control and, in the long term, reducing progression to myelofibrosis.SPRINGER2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12239https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137306096&doi=10.1007%2fs00277-022-04963-z&partnerID=40&md5=3ddc7b53703f3c2298a6a25268b0c945ANNALS OF HEMATOLOGYISSN: 09395555ISSNe: 14320584reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p122392026-06-14T12:41:47Z
dc.title.none.fl_str_mv Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
title Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
spellingShingle Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
Triguero, A
Polycythemia vera
Low-risk
Phlebotomies
Thrombosis
Myelofibrosis
title_short Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
title_full Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
title_fullStr Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
title_full_unstemmed Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
title_sort Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
dc.creator.none.fl_str_mv Triguero, A
Pedraza, A
Perez-Encinas, M
Mata-Vazquez, MI
Velez, P
Fox, L
Gomez-Calafat, M
Garcia-Delgado, R
Gasior, M
Ferrer-Marin, F
Garcia-Gutierrez, V
Angona, A
Gomez-Casares, MT
Cuevas, B
Martinez, C
Perez, R
Raya, JM
Guerrero, L
Murillo, I
Bellosillo, B
Hernandez-Boluda, JC
Sanz, C
Alvarez-Larran, A
author Triguero, A
author_facet Triguero, A
Pedraza, A
Perez-Encinas, M
Mata-Vazquez, MI
Velez, P
Fox, L
Gomez-Calafat, M
Garcia-Delgado, R
Gasior, M
Ferrer-Marin, F
Garcia-Gutierrez, V
Angona, A
Gomez-Casares, MT
Cuevas, B
Martinez, C
Perez, R
Raya, JM
Guerrero, L
Murillo, I
Bellosillo, B
Hernandez-Boluda, JC
Sanz, C
Alvarez-Larran, A
author_role author
author2 Pedraza, A
Perez-Encinas, M
Mata-Vazquez, MI
Velez, P
Fox, L
Gomez-Calafat, M
Garcia-Delgado, R
Gasior, M
Ferrer-Marin, F
Garcia-Gutierrez, V
Angona, A
Gomez-Casares, MT
Cuevas, B
Martinez, C
Perez, R
Raya, JM
Guerrero, L
Murillo, I
Bellosillo, B
Hernandez-Boluda, JC
Sanz, C
Alvarez-Larran, A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Polycythemia vera
Low-risk
Phlebotomies
Thrombosis
Myelofibrosis
topic Polycythemia vera
Low-risk
Phlebotomies
Thrombosis
Myelofibrosis
description Hematological control, incidence of complications, and need for cytoreduction were studied in 453 patients with low-risk polycythemia vera (PV) treated with phlebotomies alone. Median hematocrit value decreased from 54% at diagnosis to 45% at 12 months, and adequate hematocrit control over time (<45%) was observed in 36%, 44%, and 32% of the patients at 6, 12, and 24 months, respectively. More than 5 phlebotomies per year in the maintenance phase were required in 19% of patients. Worsening thrombocytosis, age > 60 years, and microvascular symptoms constituted the main indications for starting cytoreduction. Median duration without initiating cytoreduction was significantly longer in patients younger than 50 years (< 0.0001). The incidence rate of thrombosis under phlebotomies alone was 0.8% per year and the estimated probability of thrombosis at 10 years was 8.5%. The probability of arterial thrombosis was significantly higher in patients with arterial hypertension whereas there was a trend to higher risk of venous thrombosis in cases with high JAK2V617F allele burden. Rates of major bleeding and second primary neoplasm were low. With a median follow-up of 9 years, survival probability at 10 years was 97%, whereas the probability of myelofibrosis at 10 and 20 years was 7% and 20%, respectively. Progression to acute myeloid leukemia was documented in 3 cases (1%). Current management of low-risk PV patients is associated with low rate of thrombosis and long survival. New treatment strategies are needed for improving hematological control and, in the long term, reducing progression to myelofibrosis.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12239
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137306096&doi=10.1007%2fs00277-022-04963-z&partnerID=40&md5=3ddc7b53703f3c2298a6a25268b0c945
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=12239
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85137306096&doi=10.1007%2fs00277-022-04963-z&partnerID=40&md5=3ddc7b53703f3c2298a6a25268b0c945
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER
publisher.none.fl_str_mv SPRINGER
dc.source.none.fl_str_mv ANNALS OF HEMATOLOGY
ISSN: 09395555
ISSNe: 14320584
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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