与匹配的对照人群相比,60岁以上的成年人患有血小板缩的血液性恶性瘤风险增加:是时候进行前期骨髓评估了吗?
A Vijenthira1, A S Wilton2, S Lee3
1Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
British journal of haematology
|July 29, 2024
概括
在老年人 (≥60岁) 中,孤立的血小板缺血显著增加患有血液性恶性瘤的风险. 这一发现支持这些患者的诊断测试,包括骨髓活检 (BMB).
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 内部医学 内部医学
背景情况:
- 关于隔离性血栓缩的骨髓吸血/活检 (BMB) 存在相互矛盾的国际指导方针.
- 在老年人中,孤立的血小板缺血需要进一步调查,因为潜在的潜在血液恶性瘤.
研究的目的:
- 确定隔离性血小板缺血与60岁及以上患者血液性恶性瘤发病率之间的关联.
- 为了为老年患者提供诊断工作建议,他们呈现出孤立的血小板缺血症.
主要方法:
- 对60岁以上的患者 (2009-2019) 进行了以人口为基础的回顾性队列研究.
- 血液恶性瘤发病率的比较 患者与孤立的血小板缺血 (血小板数 <100 × 109/L,正常的WBC/Hgb) 和对照.
- 竞争死亡风险模型用于初级结果分析.
主要成果:
- 与对照组 (2,5/1000PY) 相比,患有孤立血小板衰竭的患者血性恶性病发病率显著更高 (19.1/1000PY).
- 血液性恶性瘤的危险比率在第一年为15.5,在随后的几年为5.3.
- 这种关联在各种分层中仍然很显著,包括年龄,性别,血栓塞缩症的严重程度和皮质类固醇的使用.
结论:
- 在60岁以上的患者中,孤立的血小板缩与血液性恶性瘤的风险增加密切相关.
- 在老年患者中,应考虑进行诊断评估,可能包括骨髓活检 (BMB).
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