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在患有基本血小板血和极端血小板血症的患者中发生出血的风险
Rathnam K Venkat1, Robert A Redd2, Amyah C Harris3
1Department of Medicine, Tufts University School of Medicine, Boston, MA.
Blood advances
|September 18, 2024
概括
在基本血小板血 (ET) 中,极端血小板血 (ExT) 不会增加出血风险. 仅仅基于高血小板数量,细胞减少可能是不必要的,因为在ExT和非ExT患者中,出血和血栓形成率相似.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 血栓形成研究研究
背景情况:
- 基本血小板血 (ET) 影响大约25%的极端血小板血 (ExT) 患者,定义为血小板计数≥1000 × 10^9/L.
- 由于获得的·维勒布兰德综合征,ExT患者可能面临更高的出血风险.
研究的目的:
- 以追溯分析ExT患者的出血和血栓形成风险,与ET患者的非ExT患者相比.
- 根据ET患者与ExT.的细胞减少有关治疗决策的信息.
主要方法:
- 在丹娜-法伯癌症研究所和马萨诸塞总医院2014-2022年ET患者的回顾性分析.
- 从医疗记录中抽象的重大出血,临床相关的非重大出血 (CRNMB) 和血栓事件的数据.
- 在ExT和非ExT组之间比较出血和血栓的累积发病率.
主要成果:
- 确定了128名ExT患者 (28%) 和323名非ExT患者 (72%).
- 在ExT和非ExT组之间,大出血 (21%对13%) 或CRNMB (16%对15%) 的累积发病率没有显著差异.
- 在ExT和非ExT组之间,血栓形成的累积发病率 (28%与25%) 没有差异.
结论:
- 在ExT和非ExTET患者之间,出血风险没有显著差异.
- 细胞减少可能不仅仅是为了管理ET患者的出血风险至关重要,其血小板数量为100万或更高.
- 糖尿病和DNMT3A突变被确定为ET患者出血的新风险因素.
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