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Long-term clinical outcomes of patients with hematologically unexplained cytopenia after routine assessment: A single

Morten Munk Johansen1, Michael Asger Andersen1, Kirsten Grønbaek1

  • 1Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

European Journal of Haematology
|July 21, 2018
PubMed

Insights

Patients with unexplained cytopenia (UC) face a significantly higher risk of developing hematological diseases, cancers, and liver or rheumatic conditions. This condition also leads to increased mortality, particularly in older adults.

Area of Science:

  • Hematology
  • Oncology
  • Internal Medicine

Background:

  • Unexplained cytopenia (UC) is a condition characterized by low blood cell counts without a clear cause.
  • Long-term outcomes for patients with UC are not well-established.
  • Identifying risks associated with UC is crucial for patient management and prognosis.

Purpose of the Study:

  • To investigate the long-term risk of malignant hematological diseases, cancers, and other significant non-malignant conditions in patients with UC.
  • To assess the overall mortality rates in patients diagnosed with UC compared to a matched control population.

Main Methods:

  • A cohort of 221 patients with UC was identified from 1820 referrals to a hematology outpatient clinic.
  • Registry linkage was used to obtain ICD-10 diagnoses and survival data.
  • Cumulative incidences and hazard ratios for mortality were calculated and compared to a control group, adjusting for relevant factors.

Main Results:

  • Patients with UC showed a 5-year cumulative incidence of malignant hematological disease of 8.91%, significantly higher than controls (0.93%).
  • Increased incidences of cancer, liver disease, and rheumatic disease were observed in the UC cohort.
  • Adjusted analysis revealed a 1.43 hazard ratio for all-cause mortality in UC patients compared to controls, with higher risks noted in those aged 50 and above.

Conclusions:

  • Unexplained cytopenia is associated with a substantially elevated risk of developing hematological malignancies, various cancers, and other serious conditions.
  • Patients with UC experience increased mortality compared to the general population.
  • The findings underscore the importance of vigilant monitoring and management for individuals diagnosed with unexplained cytopenia, especially older patients.
Abstract

Keywords:
Idiopathic cytopenia of undetermined significanceanemiacomorbiditycytopeniamyelodysplastic syndromethrombocytopenia

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