Document Detail


Perspectives on thrombosis in essential thrombocythemia and polycythemia vera: is leukocytosis a causative factor?
MedLine Citation:
PMID:  19372254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Leukocyte (WBC) count has been recently identified as an independent predictor of major thrombosis in both essential thrombocythemia (ET) and polycythemia vera (PV). However, whether leukocytosis should be simply considered a marker for vascular disease or whether elevated WBC levels actually contribute directly to causing such disorders is presently matter of many studies. By adopting epidemiologic criteria for causation, we have examined the characteristics to support this association such as (1) strength, (2) consistency, (3) specificity, (4) temporality, (5) biologic gradient, (6) plausibility, (7) experimental evidence, and (8) analogy. Our conclusion supports the notion that baseline leukocytosis in ET and PV patients adds prognostic significance to existing risk factors and that may be considered causative of vascular events. These developments could induce clinicians to incorporate WBC count into standard clinical practice. However, we need prospective clinical studies with stratification of patients according to their baseline leukocyte counts. Until such evidence is available, the decision on how to manage these patients should continue to follow conventional criteria.
Authors:
Tiziano Barbui; Alessandra Carobbio; Alessandro Rambaldi; Guido Finazzi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-04-16
Journal Detail:
Title:  Blood     Volume:  114     ISSN:  1528-0020     ISO Abbreviation:  Blood     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-08-10     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  759-63     Citation Subset:  AIM; IM    
Affiliation:
Hematology Division, Ospedali Riuniti, Largo Barozzi 1, Bergamo, Italy. tbarbui@ospedaliriuniti.bergamo.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cohort Studies
Disease Susceptibility
Follow-Up Studies
Humans
Leukocyte Count
Leukocytosis / complications*
Middle Aged
Platelet Count
Polycythemia Vera / complications*
Risk Factors
Sensitivity and Specificity
Thrombocythemia, Essential / complications*
Thrombosis / etiology*
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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