在多细胞真血症中,白细胞计数升高与血栓事件之间的关联:REVEAL的分析
Aaron T Gerds1, Ruben Mesa2, John M Burke3
1Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.
Blood
|December 24, 2023
概括
升高的白细胞 (WBC) 计数是多细胞真血病 (PV) 患者中发生血栓事件 (TEs) 的重要危险因素,独立于血红素. 控制WBC数量对于管理PV和预防TE至关重要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床研究 临床研究
背景情况:
- 多细胞血病真 (PV) 是一种骨髓增殖性瘤,具有发生血栓事件 (TE) 的风险增加.
- 已确立的TEs的PV风险因素包括年龄,先前的TE史和升高的血红素.
- 增加白细胞 (WBC) 计数与PV中的TEs之间的关联需要进一步验证.
研究的目的:
- 为了前性地研究白细胞计数和PV患者中TEs发生的相关性.
- 为了评估WBC计数对PV中TE风险的独立贡献,考虑已确定的风险因素.
主要方法:
- 在美国临床实践中对2510名PV患者进行前性观察性研究 (REVEAL).
- 使用时间依赖的共变Cox比例危险模型来分析血液样本和临床数据.
- 在447个月的中位随访期间,在2271名参与者中,在106名患者中发现了142例试验性病变.
主要成果:
- 升高的血红素值 (>45%) 和白细胞计数 (>11 × 10 ^ 9 / L) 与初始TE发生有显著关联.
- 升高的白细胞计数独立预测了低风险和高风险PV患者的初始TE发生.
- 即使在血红素控制在≤45%时,白血球计数>12 × 10 ^ 9 / L仍然与TE发生有显著的关联.
结论:
- 白细胞计数应纳入光伏风险分层策略.
- 控制血红素和白血球计数对于管理PV和预防血栓事件很重要.
- 需要进一步研究针对PV中的白细胞计数的治疗策略.
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