The rate of progression to polycythemia vera or essential thrombocythemia in patients with erythrocytosis or thrombocytosis

Article Abstract:

Background: The clinical relevance of mild erythrocytosis (hematocrit > 0.48 in women or > 0.51 in men) or thrombocytosis (platelet count > 400 x 10(super 9) cells/L) in asymptomatic persons is uncertain. Objective: To estimate the frequency of polycythemia vera or essential thrombocythemia in persons with erythrocytosis or thrombocytosis in a general population. Design: Cohort study. Setting: Vincenza, Italy. Participants: 10 000 community dwellers age 18 to 65 years and enrolled in the Vicenza Thrombophilia and Atherosclerosis project. Measurements: Platelet count and hematocrit at baseline in all participants and at second follow-up if baseline results were abnormal. Measurement of erythrocyte sedimentation rate, peripheral arterial saturation, serum erythropoietin level, and leukocyte alkaline phosphatase level; chest radiography; abdominal ultrasonography; and occult fecal blood testing were done in persons with confirmed high hematocrit or platelet counts. Polycythemia vera and essential thrombocythemia were diagnosed according to the Polycythemia Study Group criteria. Results: At baseline examination, 1 person had polycythemia vera, 1 had essential thrombocythemia, 88 had erythrocytosis, and 99 had thrombocytosis. Second examination confirmed erythrocytosis in 40% (95% CI, 29% to 51%) and thrombocytosis in 8% (CI, 4% to 15%) of those with abnormal baseline results. Among persons with confirmed abnormalities, further evaluation revealed 11 with idiopathic erythrocytosis, 2 with polycythemia vera (3/10 000 [CI, 0.6 to 8.7/10 000]), and 3 with essential thrombocythemia (4/10 000 [CI, 10.09 to 10.2/10 000]). After 5 years of follow-up, 1 additional person with a high platelet count developed essential thrombocythemia, and no persons developed hemorrhagic or thrombotic complications. Conclusions: The prevalences of polycythemia vera and essential thrombocythemia were higher than expected in this general population. However, the risks for developing polycythemia vera, essential thrombocythemia, or associated vascular complications in persons with erythrocytosis or thrombocytosis were low.

Development and progression, Thrombocytosis, Polycythemia vera, Author Abstract, Thrombocythemia

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Hydroxyurea for patients with essential thrombocythemia and a higher risk of thrombosis

Article Abstract:

The drug hydroxyurea may successfully lower platelet counts and consequently reduce the risk of blood clots and strokes in people with high platelet counts. Of 114 patients with platelet counts over 600,000 per cubic millimeter, 56 took took enough hydroxyurea daily to maintain their platelet counts below 600,000 and 58 took a placebo. Two of the patients who took hydroxyurea developed blood clots that caused various complications compared to 14 of the patients who took a placebo. The platelet counts of those taking hydroxyurea dropped below 600,000 per cubic millimeter within two to eight weeks of treatment, and stayed there as long as treatment continued. The average follow-up time was 27 months.

Evaluation, Prevention, Drug therapy, Thrombosis, Hydroxyurea, Blood platelet disorders, Platelet function disorders

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Activated Protein C Resistance and Factor V Leiden Mutation Are Independent Risk Factors for Venous Thromboembolism

Article Abstract:

Activated protein C resistance and factor V Leiden mutation increase the risk of thromboembolism. Both blood clotting disorders can cause inappropriate clot formation. Researchers tested 15,109 people in Italy for the mutation and protein C resistance. Factor V Leiden mutation carriers had about three times the risk of thromboembolism as those without the mutation. Those with activated protein C resistance had nearly twice the risk of thromboembolism. Thromboembolic events were most likely following surgery.

Italy, Complications and side effects, Risk factors, Blood clotting disorders, Blood coagulation disorders, Thromboembolism

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