Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation
The role of antiplatelet therapy as primary prophylaxis of thrombosis in low-risk essential thrombocythemia has not been studied in randomized clinical trials. We assessed the benefit/risk of lowdose aspirin in 433 patients with low-risk essential thrombocythemia (271 with a CALR mutation, 162 with...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2016 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:2445/108856 |
| Acceso en línea: | https://hdl.handle.net/2445/108856 |
| Access Level: | acceso abierto |
| Palabra clave: | Trombosi Plaquetes sanguínies Malalties hematològiques Thrombosis Blood platelets Hematologic diseases |
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Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutationÁlvarez Larrán, AlbertoPereira Saavedra, ArturoGuglielmelli, PaolaHernández Boluda, Juan CarlosArellano Rodrigo, EduardoFerrer Marín, FranciscaSamah, AlimamGriesshammer, MartinKerguelen Fuentes, AnaAndreasson, BjornBurgaleta, CarmenSchwarz, JiriGarcía Gutiérrez, ValentínAyala, RosaBarba, PereGómez Casares, María TeresaPaoli, ChiaraDrexler, BeatriceZweegman, SonjaMcMullin, Mary F.Samuelsson, JanHarrison, Claire N.Cervantes Requena, F.Vannucchi, Alessandro M.Besses, CarlosTrombosiPlaquetes sanguíniesMalalties hematològiquesThrombosisBlood plateletsHematologic diseasesThe role of antiplatelet therapy as primary prophylaxis of thrombosis in low-risk essential thrombocythemia has not been studied in randomized clinical trials. We assessed the benefit/risk of lowdose aspirin in 433 patients with low-risk essential thrombocythemia (271 with a CALR mutation, 162 with a JAK2V617F mutation) who were on antiplatelet therapy or observation only. After a follow up of 2215 person- years free from cytoreduction, 25 thrombotic and 17 bleeding episodes were recorded. In CALR-mutated patients, antiplatelet therapy did not affect the risk of thrombosis but was associated with a higher incidence of bleeding (12.9 versus 1.8 episodes per 1000 patient-years, P=0.03). In JAK2V617F-mutated patients, low-dose aspirin was associated with a reduced incidence of venous thrombosis with no effect on the risk of bleeding. Coexistence of JAK2V617F-mutation and cardiovascular risk factors increased the risk of thrombosis, even after adjusting for treatment with low-dose aspirin (incidence rate ratio: 9.8; 95% confidence interval: 2.3-42.3; P=0.02). Time free from cytoreduction was significantly shorter in CALR-mutated patients with essential thrombocythemia than in JAK2V617F-mutated ones (median time 5 years and 9.8 years, respectively; P=0.0002) and cytoreduction was usually necessary to control extreme thrombocytosis. In conclusion, in patients with low-risk, CALR-mutated essential thrombocythemia, low-dose aspirin does not reduce the risk of thrombosis and may increase the risk of bleeding.Ferrata Storti Foundation2017201720162017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion6 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/108856Articles publicats en revistes (Medicina)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3324/haematol.2016.146654Haematologica, 2016, vol. 101, num. 8, p. 926-931https://doi.org/10.3324/haematol.2016.146654(c) Ferrata Storti Foundation, 2016info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1088562026-05-29T05:05:01Z |
| dc.title.none.fl_str_mv |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation |
| title |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation |
| spellingShingle |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation Álvarez Larrán, Alberto Trombosi Plaquetes sanguínies Malalties hematològiques Thrombosis Blood platelets Hematologic diseases |
| title_short |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation |
| title_full |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation |
| title_fullStr |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation |
| title_full_unstemmed |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation |
| title_sort |
Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation |
| dc.creator.none.fl_str_mv |
Álvarez Larrán, Alberto Pereira Saavedra, Arturo Guglielmelli, Paola Hernández Boluda, Juan Carlos Arellano Rodrigo, Eduardo Ferrer Marín, Francisca Samah, Alimam Griesshammer, Martin Kerguelen Fuentes, Ana Andreasson, Bjorn Burgaleta, Carmen Schwarz, Jiri García Gutiérrez, Valentín Ayala, Rosa Barba, Pere Gómez Casares, María Teresa Paoli, Chiara Drexler, Beatrice Zweegman, Sonja McMullin, Mary F. Samuelsson, Jan Harrison, Claire N. Cervantes Requena, F. Vannucchi, Alessandro M. Besses, Carlos |
| author |
Álvarez Larrán, Alberto |
| author_facet |
Álvarez Larrán, Alberto Pereira Saavedra, Arturo Guglielmelli, Paola Hernández Boluda, Juan Carlos Arellano Rodrigo, Eduardo Ferrer Marín, Francisca Samah, Alimam Griesshammer, Martin Kerguelen Fuentes, Ana Andreasson, Bjorn Burgaleta, Carmen Schwarz, Jiri García Gutiérrez, Valentín Ayala, Rosa Barba, Pere Gómez Casares, María Teresa Paoli, Chiara Drexler, Beatrice Zweegman, Sonja McMullin, Mary F. Samuelsson, Jan Harrison, Claire N. Cervantes Requena, F. Vannucchi, Alessandro M. Besses, Carlos |
| author_role |
author |
| author2 |
Pereira Saavedra, Arturo Guglielmelli, Paola Hernández Boluda, Juan Carlos Arellano Rodrigo, Eduardo Ferrer Marín, Francisca Samah, Alimam Griesshammer, Martin Kerguelen Fuentes, Ana Andreasson, Bjorn Burgaleta, Carmen Schwarz, Jiri García Gutiérrez, Valentín Ayala, Rosa Barba, Pere Gómez Casares, María Teresa Paoli, Chiara Drexler, Beatrice Zweegman, Sonja McMullin, Mary F. Samuelsson, Jan Harrison, Claire N. Cervantes Requena, F. Vannucchi, Alessandro M. Besses, Carlos |
| author2_role |
author author 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 |
Trombosi Plaquetes sanguínies Malalties hematològiques Thrombosis Blood platelets Hematologic diseases |
| topic |
Trombosi Plaquetes sanguínies Malalties hematològiques Thrombosis Blood platelets Hematologic diseases |
| description |
The role of antiplatelet therapy as primary prophylaxis of thrombosis in low-risk essential thrombocythemia has not been studied in randomized clinical trials. We assessed the benefit/risk of lowdose aspirin in 433 patients with low-risk essential thrombocythemia (271 with a CALR mutation, 162 with a JAK2V617F mutation) who were on antiplatelet therapy or observation only. After a follow up of 2215 person- years free from cytoreduction, 25 thrombotic and 17 bleeding episodes were recorded. In CALR-mutated patients, antiplatelet therapy did not affect the risk of thrombosis but was associated with a higher incidence of bleeding (12.9 versus 1.8 episodes per 1000 patient-years, P=0.03). In JAK2V617F-mutated patients, low-dose aspirin was associated with a reduced incidence of venous thrombosis with no effect on the risk of bleeding. Coexistence of JAK2V617F-mutation and cardiovascular risk factors increased the risk of thrombosis, even after adjusting for treatment with low-dose aspirin (incidence rate ratio: 9.8; 95% confidence interval: 2.3-42.3; P=0.02). Time free from cytoreduction was significantly shorter in CALR-mutated patients with essential thrombocythemia than in JAK2V617F-mutated ones (median time 5 years and 9.8 years, respectively; P=0.0002) and cytoreduction was usually necessary to control extreme thrombocytosis. In conclusion, in patients with low-risk, CALR-mutated essential thrombocythemia, low-dose aspirin does not reduce the risk of thrombosis and may increase the risk of bleeding. |
| publishDate |
2016 |
| dc.date.none.fl_str_mv |
2016 2017 2017 2017 |
| 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://hdl.handle.net/2445/108856 |
| url |
https://hdl.handle.net/2445/108856 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Reproducció del document publicat a: https://doi.org/10.3324/haematol.2016.146654 Haematologica, 2016, vol. 101, num. 8, p. 926-931 https://doi.org/10.3324/haematol.2016.146654 |
| dc.rights.none.fl_str_mv |
(c) Ferrata Storti Foundation, 2016 info:eu-repo/semantics/openAccess |
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(c) Ferrata Storti Foundation, 2016 |
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openAccess |
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6 p. application/pdf application/pdf |
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Ferrata Storti Foundation |
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Ferrata Storti Foundation |
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Articles publicats en revistes (Medicina) reponame:Recercat. Dipósit de la Recerca de Catalunya instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
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Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
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Recercat. Dipósit de la Recerca de Catalunya |
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Recercat. Dipósit de la Recerca de Catalunya |
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