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Article: Long-term outcome of 231 patients with essential thrombocythemia: Prognostic factors for thrombosis, bleeding, myelofibrosis, and leukemia

TitleLong-term outcome of 231 patients with essential thrombocythemia: Prognostic factors for thrombosis, bleeding, myelofibrosis, and leukemia
Authors
Issue Date2005
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archinternmed.com
Citation
Archives Of Internal Medicine, 2005, v. 165 n. 22, p. 2651-2658 How to Cite?
AbstractBackground: Essential thrombocythemia (ET) is a clonal myeloproliferative disease associated with thrombohemorrhagic complications and myeloid transformation to diseases such as myelofibrosis and acute myeloid leukemia. Methods: A multicenter study was conducted among 231 consecutive Chinese patients with ET. The literature about leukemogenic risk associated with the use of hydroxyurea therapy was reviewed. Results: The median patient age was 65 years. Thrombosis rates at and after diagnosis of ET were comparable to those of white patients, but bleeding rates at and after diagnosis were much lower. The projected 10-year thrombosis-free, bleeding-free, and overall survival rates were 66%, 83%, and 80%, respectively. There were no deaths among patients 60 years or younger during a maximum follow-up of 15 years, and splenomegaly at diagnosis of ET appeared to protect against thrombosis. In multivariate analysis, advanced age predicted inferior 10-year thrombosis-free and overall survival, and male sex predicted inferior bleeding-free survival. Half the deaths were related to ET. The probability of myelofibrosis transformation was 9.7% at 10 years. Prior myelofibrosis (P=.008) and the use of melphalan treatment (P=.002) were risk factors for acute myeloid leukemia evolution. Conclusions: Essential thrombocythemia is a benign disease of older persons. Chinese patients have a low risk of bleeding, and prior myelofibrosis is a major risk factor for evolution to acute myeloid leukemia. Leukemic transformation with hydroxyurea therapy alone is rare and warrants further prospective studies. ©2005 American Medical Association. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/76992
ISSN
2014 Impact Factor: 17.333
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChim, CSen_HK
dc.contributor.authorKwong, YLen_HK
dc.contributor.authorLie, AKWen_HK
dc.contributor.authorMa, SKen_HK
dc.contributor.authorChan, CCen_HK
dc.contributor.authorWong, LGen_HK
dc.contributor.authorKho, BCSen_HK
dc.contributor.authorLee, HKen_HK
dc.contributor.authorSim, JPYen_HK
dc.contributor.authorChan, CHen_HK
dc.contributor.authorChan, JCWen_HK
dc.contributor.authorYeung, YMen_HK
dc.contributor.authorLaw, Men_HK
dc.contributor.authorLiang, Ren_HK
dc.date.accessioned2010-09-06T07:27:06Z-
dc.date.available2010-09-06T07:27:06Z-
dc.date.issued2005en_HK
dc.identifier.citationArchives Of Internal Medicine, 2005, v. 165 n. 22, p. 2651-2658en_HK
dc.identifier.issn0003-9926en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76992-
dc.description.abstractBackground: Essential thrombocythemia (ET) is a clonal myeloproliferative disease associated with thrombohemorrhagic complications and myeloid transformation to diseases such as myelofibrosis and acute myeloid leukemia. Methods: A multicenter study was conducted among 231 consecutive Chinese patients with ET. The literature about leukemogenic risk associated with the use of hydroxyurea therapy was reviewed. Results: The median patient age was 65 years. Thrombosis rates at and after diagnosis of ET were comparable to those of white patients, but bleeding rates at and after diagnosis were much lower. The projected 10-year thrombosis-free, bleeding-free, and overall survival rates were 66%, 83%, and 80%, respectively. There were no deaths among patients 60 years or younger during a maximum follow-up of 15 years, and splenomegaly at diagnosis of ET appeared to protect against thrombosis. In multivariate analysis, advanced age predicted inferior 10-year thrombosis-free and overall survival, and male sex predicted inferior bleeding-free survival. Half the deaths were related to ET. The probability of myelofibrosis transformation was 9.7% at 10 years. Prior myelofibrosis (P=.008) and the use of melphalan treatment (P=.002) were risk factors for acute myeloid leukemia evolution. Conclusions: Essential thrombocythemia is a benign disease of older persons. Chinese patients have a low risk of bleeding, and prior myelofibrosis is a major risk factor for evolution to acute myeloid leukemia. Leukemic transformation with hydroxyurea therapy alone is rare and warrants further prospective studies. ©2005 American Medical Association. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archinternmed.comen_HK
dc.relation.ispartofArchives of Internal Medicineen_HK
dc.subject.meshAcute Diseaseen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAge Factorsen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAntineoplastic Agents - therapeutic useen_HK
dc.subject.meshAsian Continental Ancestry Groupen_HK
dc.subject.meshCell Transformation, Neoplasticen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHydroxyurea - therapeutic useen_HK
dc.subject.meshLeukemia, Myeloid - epidemiology - pathologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMelphalan - therapeutic useen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMultivariate Analysisen_HK
dc.subject.meshMyeloablative Agonists - therapeutic useen_HK
dc.subject.meshPrimary Myelofibrosis - epidemiologyen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshSex Factorsen_HK
dc.subject.meshSplenomegalyen_HK
dc.subject.meshSurvival Analysisen_HK
dc.subject.meshThrombocythemia, Essential - complications - drug therapy - mortalityen_HK
dc.subject.meshThrombosis - epidemiologyen_HK
dc.subject.meshbeta-Thalassemia - epidemiologyen_HK
dc.titleLong-term outcome of 231 patients with essential thrombocythemia: Prognostic factors for thrombosis, bleeding, myelofibrosis, and leukemiaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-9926&volume=165&issue=22&spage=2651&epage=8&date=2005&atitle=Long-term+outcome+of+231+patients+with+essential+thrombocythemia:+prognostic+factors+for+thrombosis,+bleeding,+myelofibrosis,+and+leukemiaen_HK
dc.identifier.emailChim, CS:jcschim@hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.emailLiang, R:rliang@hku.hken_HK
dc.identifier.authorityChim, CS=rp00408en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.identifier.authorityLiang, R=rp00345en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1001/archinte.165.22.2651en_HK
dc.identifier.pmid16344424-
dc.identifier.scopuseid_2-s2.0-28944455594en_HK
dc.identifier.hkuros150924en_HK
dc.identifier.hkuros121986-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-28944455594&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume165en_HK
dc.identifier.issue22en_HK
dc.identifier.spage2651en_HK
dc.identifier.epage2658en_HK
dc.identifier.isiWOS:000233883800018-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChim, CS=7004597253en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.scopusauthoridLie, AKW=7004510870en_HK
dc.identifier.scopusauthoridMa, SK=9042504200en_HK
dc.identifier.scopusauthoridChan, CC=7404814272en_HK
dc.identifier.scopusauthoridWong, LG=35793809000en_HK
dc.identifier.scopusauthoridKho, BCS=54880874500en_HK
dc.identifier.scopusauthoridLee, HK=15136323100en_HK
dc.identifier.scopusauthoridSim, JPY=8501560000en_HK
dc.identifier.scopusauthoridChan, CH=55031168000en_HK
dc.identifier.scopusauthoridChan, JCW=9940606800en_HK
dc.identifier.scopusauthoridYeung, YM=9941021000en_HK
dc.identifier.scopusauthoridLaw, M=9941188500en_HK
dc.identifier.scopusauthoridLiang, R=26643224900en_HK

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