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|Title:||Antiplatelet therapy versus observation in low-risk essential thrombocythemia with CALR mutation|
Pereira Saavedra, Arturo
Hernández Boluda, Juan Carlos
Arellano Rodrigo, Eduardo
Ferrer Marín, Francisca
García Gutiérrez, Valentín
Gómez Casares, María Teresa
McMullin, Mary F.
Cervantes Requena, F.
Vannucchi, Alessandro M.
|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.|
|Note:||Reproducció del document publicat a: https://doi.org/10.3324/haematol.2016.146654|
|It is part of:||Haematologica, 2016, vol. 101, num. 8, p. 926-931|
|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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