Application of IPSET-thrombosis in 1366 Patients Prospectively Followed From the Spanish Registry of Essential...

Area of Science:

• Hematology
• Oncology
• Clinical Medicine

Background:

• Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by increased platelet counts.
• Thrombosis is a major complication in ET, necessitating accurate risk stratification for prevention strategies.
• The International Prognostic Score of thrombosis in Essential Thrombocythemia (IPSET-thrombosis) and its revised version aim to guide these strategies.

Purpose of the Study:

• To evaluate the prognostic capability of IPSET-thrombosis and revised IPSET-thrombosis for predicting thrombosis in ET patients.
• To assess the performance of these scores in differentiating arterial versus venous thrombosis risk.
• To analyze thrombosis rates in specific risk categories, including intermediate-risk revised IPSET-thrombosis patients.

Main Methods:

• Prospective follow-up of 1366 ET patients from the Spanish Registry of ET.
• Evaluation of cumulative incidence of thrombosis over 10 years, considering death as a competing risk.
• Analysis of arterial and venous thrombosis separately using subdistribution hazard ratios (SHR).

Main Results:

• The cumulative incidence of thrombosis at 10 years was 11.4%.
• High-risk IPSET-thrombosis and revised IPSET-thrombosis scores significantly predicted increased arterial thrombosis risk (SHR 3.7 and 3.2, respectively).
• Both scoring systems failed to predict venous thrombosis; intermediate-risk revised IPSET-thrombosis patients showed very low thrombosis incidence.

Conclusions:

• IPSET-thrombosis scores are valuable for identifying ET patients at high risk of arterial thrombosis.
• These scores are not effective in predicting venous thrombosis in ET.
• Further controlled studies are required to establish optimal treatment for non-high-risk ET patients.