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Title: Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation
Author: Alvarez-Larrán, Alberto
Pereira Saavedra, Arturo
Guglielmelli, Paola
Hernández Boluda, Juan Carlos
Arellano Rodrigo, Eduardo
Ferrer Marín, Francisca
Samah, Alimam
Griesshammer, Martin
Kerguelen, Ana
Andreasson, Bjorn
Burgaleta, Carmen
Schwarz, Jiri
García Gutiérrez, Valentín
Ayala, Rosa
Barba, Pere
Gómez Casares, María Teresa
Paoli, Chiara
Drexler, Beatrice
Zweegman, Sonja
McMullin, Mary F.
Samuelsson, Jan
Harrison, Claire
Cervantes Requena, F.
Vannucchi, Alessandro M.
Besses, Carlos
Keywords: Trombosi
Plaquetes sanguínies
Malalties hematològiques
Blood platelets
Hematologic diseases
Issue Date: 1-Aug-2016
Publisher: Ferrata Storti Foundation
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 lowdose aspirin in 433 patients with low-risk essential thrombocythemia (271 with a CALR mutation, 162 with a JAK2V617F 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 JAK2V617F-mutated patients, low-dose aspirin was associated with a reduced incidence of venous thrombosis with no effect on the risk of bleeding. Coexistence of JAK2V617F-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 JAK2V617F-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.
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It is part of: Haematologica, 2016, vol. 101, num. 8, p. 926-931
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ISSN: 0390-6078
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Medicina)

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