Validation of previous prognostic models for thrombosis and exploration of modified models in patients with essential thrombocythemia

Eur J Haematol. 2018 Oct;101(4):508-513. doi: 10.1111/ejh.13136. Epub 2018 Aug 31.

Abstract

Objective: We examined the prognostic factors to validate previous prognostic models for survival and thrombosis with large-scale data on Japanese patients with essential thrombocythemia (ET).

Method: We conducted a study in 352 patients with ET to validate previous prognostic models and search for new prognostic factors.

Results: The International Prognostic Score for essential thrombocythemia (IPSET), the conventional risk classification and the International Prognostic Score for thrombosis in essential thrombocythemia (IPSET-T) were confirmed to be reproducible in Japanese patients. However, no significant difference was observed between the low-risk and intermediate-risk categories according to the revised IPSET-T, which does not allow direct comparison of the four risk groups. We reevaluated the risk using a modified revised IPSET-T, which was derived from the revised IPSET-T by scoring the factors as follows: one point for age > 60 years, two points for past history of thrombosis, two points for JAK2 gene mutation-positive; total points of 0 = very low risk, 1 = low risk, 2 = intermediate risk, 3 and above = high risk, with significantly different thrombosis-free survival.

Conclusion: The modified revised IPSET-T has been useful for 4-group stratification to predict a population that requires therapeutic intervention, irrespective of the treatment regimens.

Keywords: IPSET-T; JAK2 mutation; essential thrombocythemia; risk classification; thrombosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Female
  • Humans
  • Janus Kinase 2 / genetics
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Risk
  • Thrombocythemia, Essential / complications*
  • Thrombocythemia, Essential / epidemiology*
  • Thrombocythemia, Essential / genetics
  • Thrombocythemia, Essential / mortality
  • Thrombosis / epidemiology*
  • Thrombosis / etiology*
  • Thrombosis / mortality
  • Young Adult

Substances

  • Biomarkers
  • Janus Kinase 2