Leukocytosis in polycythemia vera and splenomegaly in essential thrombocythemia are independent risk factors for hemorrhage

Yi Sheng Chou, Jyh Pyng Gau, Yuan Bin Yu, Jih Tung Pai, Liang Tsai Hsiao, Jin Hwang Liu, Ying Chung Hong, Chun Yu Liu, Ching Fen Yang, Po Min Chen, Tzeon Jye Chiou, Cheng Hwai Tzeng

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: Long-term outcomes are favorable for patients with polycythemia vera (PV) and for patients with essential thrombocythemia (ET). However, hemorrhage is a significant cause of morbidity and mortality in those patients. Methods: We retrospectively recruited 247 patients who had received a diagnosis of PV (n = 101) or ET (n = 146) during the period 2001-2010. Results: After a median follow-up period of 36.2 months, the cumulative incidence of hemorrhage was 39.6% in patients with PV (6.2% per person-year) and 29.7% in patients with ET (5.9% person-years). Episodes of major bleeding occurred in 9.9% of patients with PV and in 14.4% of patients with ET. Overall survival was significantly shorter among patients with hemorrhage than among those without said complication (P < 0.001 for overall patients; P = 0.002 for patients with PV; P = 0.026 for patients with ET). In the univariate analysis, age ≥60 yr (OR: 4.77, P = 0.046) and WBC ≥ 16 × 109/L (OR: 4.15, P = 0.010) were predictors of hemorrhage in patients with PV, and age ≥60 yr (OR: 3.25, P = 0.040), WBC ≥ 16 × 109/L (OR: 2.89, P = 0.024), albumin <4.0 g/dL (OR: 4.10, P = 0.002), and splenomegaly (OR: 5.19, P = 0.002) were predictors of hemorrhage in patients with ET. Multivariate analysis showed that WBC ≥ 16 × 109/L was the only significant risk factor for hemorrhage in patients with PV (OR: 3.51, P = 0.026) and that splenomegaly was the only risk factor for hemorrhage in patients with ET (OR: 3.00, P = 0.048). Conclusion: Leukocytosis in PV and splenomegaly in ET are independent risk factors for hemorrhage.

Original languageEnglish
Pages (from-to)228-236
Number of pages9
JournalEuropean Journal of Haematology
Volume90
Issue number3
DOIs
Publication statusPublished - Mar 2013
Externally publishedYes

Keywords

  • Essential thrombocythemia
  • Hemorrhage
  • Polycythemia vera
  • Risk factor

ASJC Scopus subject areas

  • Hematology

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