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Published on: April 1, 2019
JAK2V617F allele burden and thrombosis: a direct comparison in essential thrombocythemia and polycythemia vera
Alessandra Carobbio1, Guido Finazzi, Elisabetta Antonioli
1Hematology Department, Ospedali Riuniti di Bergamo, Bergamo, Italy.
Insights
Essential thrombocythemia (ET) and polycythemia vera (PV) share similar thrombosis risks over time, especially for JAK2-mutated ET patients who approach PV risk after 10-15 years.
Area of Science:
- Hematology
- Oncology
- Vascular Medicine
Background:
- Essential thrombocythemia (ET) and polycythemia vera (PV) are myeloproliferative neoplasms.
- The JAK2V617F mutation is common in both ET and PV.
- Understanding thrombosis risk in these conditions is crucial for patient management.
Purpose of the Study:
- To directly compare the incidence and risk factors of major thrombosis in ET and PV.
- To analyze thrombosis risk based on JAK2V617F allele burden.
Main Methods:
- A comparative study involving 867 ET patients (57% JAK2V617F) and 415 PV patients (all JAK2V617F).
- Rates of major thrombosis were calculated per patient-year.
- Risk factors for thrombosis were examined.
Main Results:
- Thrombosis rates were 1.4%/patient/year for ET wild-type, 2.1% for ET JAK2V617F, and 2.7% for PV.
- Thrombosis risk increased over time, particularly in PV.
- Arterial and venous thrombosis probabilities were similar in the first 5 years.
- ET JAK2V617F patients' thrombosis risk curves diverged from wild-type ET and approached PV after 10-15 years.
Conclusions:
- Findings suggest a continuum between JAK2-mutated ET and PV.
- This continuum extends beyond hematological phenotype to vascular events.
- JAK2 mutation status influences thrombosis risk progression in ET.
Objective:
A direct comparison of the incidence and risk factors of major thrombosis in essential thrombocythemia (ET) and polycythemia vera (PV) according to their respective JAK2V617F allele burden is the object of this study.
Materials And Methods:
We compared the rate (%/patients/year) of major thrombosis in 867 ET patients (57% JAK2V617F) with that of 415 PV patients (all JAK2V617F) and examined risk factors.
Results:
Patients with ET wild-type, ET V617F, and PV showed a rate of thrombosis of 1.4%, 2.1%, and 2.7%/patients/year, respectively. The latter was found to progressively increase according to time of diagnosis. Actuarial probability of arterial and venous thrombosis in the first 5 years of diagnosis was roughly similar in the three groups. While in the subsequent periods, the curves of mutated ET patients diverged from wild-type, and after 10 to 15 years the ET-mutated arm approached PV.
Conclusion:
These findings support the concept of a continuum between ET JAK2 mutated and PV, not only in reference to the hematological phenotype, but also in terms of vascular events.
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