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Blood, 15 March 2007, Vol. 109, No. 6, pp. 2310-2313. Prepublished online as a Blood First Edition Paper on November 16, 2006; DOI 10.1182/blood-2006-09-046342. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-09-046342v1 109/6/2310    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Carobbio, A. Articles by Barbui, T. Search for Related Content PubMed PubMed Citation Articles by Carobbio, A. Articles by Barbui, T. Related Collections Hemostasis, Thrombosis, and Vascular Biology Neoplasia Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Leukocytosis is a risk factor for thrombosis in essential thrombocythemia: interaction with treatment, standard risk factors, and Jak2 mutation status Alessandra Carobbio1, Guido Finazzi1, Vittoria Guerini1, Orietta Spinelli1, Federica Delaini1, Roberto Marchioli2, Giovanna Borrelli2, Alessandro Rambaldi1, and Tiziano Barbui1 1 Divisione di Ematologia, Ospedali Riuniti di Bergamo, Bergamo, Italy; 2 Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy Leukocytes contribute to the pathogenesis of thrombosis in essential thrombocythemia (ET) through recently discovered mechanisms of activation and interaction with platelets and endothelial cells. To evaluate whether an increased leukocyte count was associated with thrombosis and whether this effect can be modulated by therapy, we analyzed the clinical course of 439 patients with ET followed at the Ospedali Riuniti di Bergamo. The strength of the association was measured at diagnosis or before thrombotic events by multivariable analyses carried out using data at baseline as well as time-varying covariates. The results showed that (1) an increased leukocyte count at diagnosis was associated with thrombosis during follow-up ("baseline analysis," relative risk [RR] 2.3, 95% confidence interval [CI] 1.4-3.9, P = .001); (2) hydroxyurea (HU) lowered leukocytosis and reduced the strength of the association between leukocytosis and thrombosis ("time-dependent analysis," RR 1.6, 95% CI 0.9-2.0, not significant [NS]); (3) the association of leukocytosis and thrombosis was more evident in untreated low-risk patients (RR 2.7, 95% CI 1.2-6.4, P = .01) compared with HU-treated high-risk patients (RR 1.6, 95% CI 0.8-3.2, NS); and (4) the presence of JAK2 V617F was not identified as a risk factor for thrombosis during follow-up despite a significant association between the mutation and leukocytosis. We suggest validation of these findings in prospective clinical studies. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: The granulocyte connection in MPD-associated thrombosis Ayalew Tefferi Blood 2007 109: 2270-2271. [Full Text] [PDF] This article has been cited by other articles: A. Carobbio, E. Antonioli, P. Guglielmelli, A. M. Vannucchi, F. Delaini, V. Guerini, G. Finazzi, A. Rambaldi, and T. Barbui Leukocytosis and Risk Stratification Assessment in Essential Thrombocythemia J. Clin. Oncol., June 1, 2008; 26(16): 2732 - 2736. [Abstract] [Full Text] [PDF] R. Landolfi and L. Di Gennaro Prevention of thrombosis in polycythemia vera and essential thrombocythemia Haematologica, March 1, 2008; 93(3): 331 - 335. [Full Text] [PDF] V. De Stefano, T. Za, E. Rossi, A. M. Vannucchi, M. Ruggeri, E. Elli, C. Mico, A. Tieghi, R. R. Cacciola, C. Santoro, et al. Recurrent thrombosis in patients with polycythemia vera and essential thrombocythemia: incidence, risk factors, and effect of treatments Haematologica, March 1, 2008; 93(3): 372 - 380. [Abstract] [Full Text] [PDF] M. 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