Key result
Elevated platelet counts (>593 G/L) were associated with a significantly shorter time to a major thrombotic event in essential thrombocythemia patients with normal white blood cell counts (P<.001).
Why the study?
Having demonstrated the impact of WBC counts on thrombotic risk in ET patients with optimized platelets, the authors sought to estimate the influence of platelet counts in patients with optimized WBC counts.
Does an elevated platelet count (>593 G/L) increase the risk of major thrombotic events in patients with essential thrombocythemia and normal white blood cell counts?
Cohort
Does an elevated platelet count (>593 G/L) increase the risk of major thrombotic events in patients with essential thrombocythemia and normal white blood cell counts?
p-value: p=<.001
In patients with essential thrombocythemia and normal white blood cell counts, maintaining platelet counts below 593 G/L is associated with a significantly reduced risk of major thrombotic events.
Supports platelet monitoring in ET with normal WBC counts; leaves open whether targeting <593 G/L reduces events prospectively.
OBJECTIVES: Cell counts have a significant impact on the complex mechanism of thrombosis in patients with essential thrombocythemia (ET). We recently demonstrated a considerable impact of white blood cell (WBC) counts on thrombotic risk in patients with optimized platelet counts by analysing a large anagrelide registry. In contrast, the current analysis of the registry aimed to estimate the influence of platelet counts on thrombotic risk in patients with optimized WBC counts. METHODS: Cox regression analysis and Kaplan-Meier plot were applied on all patients in the registry with optimized WBC counts. RESULTS: By using the calculated cut-off of 593 G/L for platelets, Cox regression analysis revealed a clear influence of elevated platelet counts on the occurrence of a major thrombotic event (P < .001). A Kaplan-Meier plot revealed a markedly shorter time to a major thrombotic event for patients with platelet counts above the cut-off (P < .001). CONCLUSIONS: The data show clear impact of platelet lowering on the thrombotic risk in ET patients with normal WBC counts. Therefore, selective platelet lowering with anagrelide appears sufficient for thrombotic risk reduction in WHO-diagnosed ET patients lacking leukocytosis.
No takes yet. Share an insight, caveat, or question.
Buxhofer‐Ausch et al. (2020) conducted a cohort in Essential thrombocythemia. Elevated platelet counts (>593 G/L) vs. Platelet counts ≤593 G/L was evaluated on Major thrombotic event (p=<.001). Elevated platelet counts (>593 G/L) were associated with a significantly shorter time to a major thrombotic event in essential thrombocythemia patients with normal white blood cell counts (P<.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: