Leucocytosis in polycythaemia vera predicts both inferior survival and leukaemic transformation

Naseema Gangat, Jacob Strand, Chin Yang Li, Wenting Wu, Animesh D Pardanani, Ayalew Tefferi

Research output: Contribution to journalArticle

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Abstract

Leucocytosis (leucocyte count >15 × 109/l) was recently associated with thrombosis in polycythaemia vera (PV). This study sought the prognostic relevance of leucocytosis for survival and leukaemic or fibrotic transformation. Amongst 459 patients with PV seen at our institution in recent years (median age, 60 years; 56% males), 146 deaths and 88 leukaemic (n = 34) or fibrotic (n = 54) transformations were documented. Arterial or venous thrombosis occurred in 14% and 9% of patients at diagnosis and in 25% and 15% during follow-up, respectively. Multivariate analysis identified the advanced age (P < 0·0001), leucocytosis (leucocyte count ≥15 × 10 9/l; P = 0·0006) and arterial thrombosis at diagnosis (P = 0·01) as independent predictors of inferior survival. In the absence of the first two risk factors, median survival was projected at 272 months as opposed to 108 months in the presence of both risk factors (P < 0·0001). Leucocytosis was also identified as an independent predictor of both leukaemic transformation and venous thrombosis during follow-up. Time-to-event analysis did not disclose a significant association between single or multiple cytotoxic drug exposure and either leukaemic or fibrotic transformation. The current study highlighted the prognostic relevance of leucocytosis on various aspects of the disease in PV.

Original languageEnglish (US)
Pages (from-to)354-358
Number of pages5
JournalBritish Journal of Haematology
Volume138
Issue number3
DOIs
StatePublished - Aug 2007

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Polycythemia Vera
Leukocytosis
Survival
Leukocyte Count
Venous Thrombosis
Thrombosis
Multivariate Analysis
Pharmaceutical Preparations

Keywords

  • JAK2
  • Leukaemia
  • Prognosis
  • Survival
  • Thrombosis

ASJC Scopus subject areas

  • Hematology

Cite this

Leucocytosis in polycythaemia vera predicts both inferior survival and leukaemic transformation. / Gangat, Naseema; Strand, Jacob; Li, Chin Yang; Wu, Wenting; Pardanani, Animesh D; Tefferi, Ayalew.

In: British Journal of Haematology, Vol. 138, No. 3, 08.2007, p. 354-358.

Research output: Contribution to journalArticle

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abstract = "Leucocytosis (leucocyte count >15 × 109/l) was recently associated with thrombosis in polycythaemia vera (PV). This study sought the prognostic relevance of leucocytosis for survival and leukaemic or fibrotic transformation. Amongst 459 patients with PV seen at our institution in recent years (median age, 60 years; 56{\%} males), 146 deaths and 88 leukaemic (n = 34) or fibrotic (n = 54) transformations were documented. Arterial or venous thrombosis occurred in 14{\%} and 9{\%} of patients at diagnosis and in 25{\%} and 15{\%} during follow-up, respectively. Multivariate analysis identified the advanced age (P < 0·0001), leucocytosis (leucocyte count ≥15 × 10 9/l; P = 0·0006) and arterial thrombosis at diagnosis (P = 0·01) as independent predictors of inferior survival. In the absence of the first two risk factors, median survival was projected at 272 months as opposed to 108 months in the presence of both risk factors (P < 0·0001). Leucocytosis was also identified as an independent predictor of both leukaemic transformation and venous thrombosis during follow-up. Time-to-event analysis did not disclose a significant association between single or multiple cytotoxic drug exposure and either leukaemic or fibrotic transformation. The current study highlighted the prognostic relevance of leucocytosis on various aspects of the disease in PV.",
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