Antiplatelet therapy versus observation in low-risk essential thrombocythemia with a CALR mutation

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author Álvarez Larrán, Albertoca
• dc.contributor.author Besses Raebel, Carlesca
• dc.date.accessioned 2016-11-18T10:52:36Z
• dc.date.available 2016-11-18T10:52:36Z
• dc.date.issued 2016
• dc.description.abstract The role of antiplatelet therapy as primary prophylaxis of thrombosis in low-risk essential thrombocythemia has not been studied in randomized clinical trials. We assessed the benefit/risk of low-dose aspirin in 433 patients with low-risk essential thrombocythemia (271 with a CALR mutation, 162 with a JAK2(V617F) mutation) who were on antiplatelet therapy or observation only. After a follow up of 2215 person-years free from cytoreduction, 25 thrombotic and 17 bleeding episodes were recorded. In CALR-mutated patients, antiplatelet therapy did not affect the risk of thrombosis but was associated with a higher incidence of bleeding (12.9 versus 1.8 episodes per 1000 patient-years, P=0.03). In JAK2(V617F)-mutated patients, low-dose aspirin was associated with a reduced incidence of venous thrombosis with no effect on the risk of bleeding. Coexistence of JAK2(V617F)-mutation and cardiovascular risk factors increased the risk of thrombosis, even after adjusting for treatment with low-dose aspirin (incidence rate ratio: 9.8; 95% confidence interval: 2.3-42.3; P=0.02). Time free from cytoreduction was significantly shorter in CALR-mutated patients with essential thrombocythemia than in JAK2(V617F)-mutated ones (median time 5 years and 9.8 years, respectively; P=0.0002) and cytoreduction was usually necessary to control extreme thrombocytosis. In conclusion, in patients with low-risk, CALR-mutated essential thrombocythemia, low-dose aspirin does not reduce the risk of thrombosis and may increase the risk of bleeding.ca
• dc.description.sponsorship This work was supported by the grants from the Instituto de Salud Carlos III, Spanish Health Ministry, PI13/00557, PI1300393, and RD012/0036/0004. Florence team was supported by AIRC project number 1005 "Special program Molecular Clinical Oncology 5x1000 to Associazione Italiana per la Ricerca sul Cancro Gruppo Italiano Malattie Mieloproliferative (AGIMM). PG was supported by AIRC IG-2014-15967."
• dc.format.mimetype application/pdfca
• dc.identifier.citation Alvarez-Larrán A, Pereira A, Guglielmelli P, Hernández-Boluda JC, Arellano-Rodrigo E, Ferrer-Marín F. et al. Antiplatelet therapy versus observation in low-risk essential thrombocythemia with a CALR mutation. Haematologica. 2016 Aug;101(8):926-31. doi: 10.3324/haematol.2016.146654ca
• dc.identifier.doi http://dx.doi.org/10.3324/haematol.2016.146654
• dc.identifier.issn 0390-6078
• dc.identifier.uri http://hdl.handle.net/10230/27542
• dc.language.iso engca
• dc.publisher Ferrata Storti Foundationca
• dc.relation.ispartof Haematologica. 2016 Aug;101(8):926-31
• dc.rights © Ferrata Storti Foundation http://dx.doi.org/10.3324/haematol.2016.146654ca
• dc.rights.accessRights info:eu-repo/semantics/openAccessca
• dc.subject.other Antiplatelet therapyca
• dc.subject.other Sistema cardiovascular -- Malaltiesca
• dc.title Antiplatelet therapy versus observation in low-risk essential thrombocythemia with a CALR mutationca
• dc.type info:eu-repo/semantics/articleca
• dc.type.version info:eu-repo/semantics/publishedVersionca