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Blood, 1 April 2005, Vol. 105, No. 7, pp. 2664-2670. Prepublished online as a Blood First Edition Paper on December 7, 2004; DOI 10.1182/blood-2004-09-3426. This Article Full Text (PDF) All Versions of this Article: 2004-09-3426v1 105/7/2664    most recent Alert me when this article is cited Alert me if a correction is posted 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 Finazzi, G. Articles by Barbui, T. Search for Related Content PubMed PubMed Citation Articles by Finazzi, G. Articles by Barbui, T. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted September 3, 2004 Accepted November 19, 2004 Acute leukemia in polycythemia vera. An analysis of 1,638 patients enrolled in a prospective observational study Guido Finazzi, Vanesa Caruso, Roberto Marchioli*, Giovanni Capnist, Teodoro Chisesi, Carlo Finelli, Luigi Gugliotta, Raffaele Landolfi, Jack Kutti, Heinz Gisslinger, Raphael Marilus, Carlo Patrono, Enrico M Pogliani, Maria L Randi, Ana Villegas, Gianni Tognoni, and Tiziano Barbui Ospedali Riuniti, Bergamo, Italy Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy Ospedale Umberto I, Venezia-Mestre, Italy Ospedale S Giovanni e Paolo, Venezia, Italy Policlinico S Orsola, Bologna, Italy Ospedale di Reggio Emilia, Reggio Emilia, Italy The Catholic University School of Medicine, Roma, Italy Sahlgrenska Hospital, Goteborg, Sweden Department of Hematology and Blood Coagulation, University of Vienna, Vienna, Austria Tel-Aviv Souraski Medical Center, Tel-Aviv, Israel University of Rome 'La Sapienza', Roma, Italy Ospedale S Gerardo, Monza, Italy Dip. Scienze Mediche e Chirurgiche, University of Padua, Padova, Italy Hospital Universitario S Carlos, Madrid, Spain * Corresponding author; email: marchioli{at}negrisud.it. Progression to acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) is a possible evolution of polycythemia vera (PV), but whether some subjects have an increased natural risk to develop this complication and how much the contribution of pharmacological cytoreduction can affect the natural course of the disease remain uncertain. The European Collaboration on Low dose Aspirin in Polycythemia Vera (ECLAP) prospective project included 1,638 patients with PV. Twenty-two cases of AML/MDS were diagnosed after a median time of 2.5 years from the recruitment in the study and 8.4 years from the diagnosis of PV. Variables associated with progression to AML/MDS were assessed using different models of multivariate analysis. Older age was confirmed as the main independent risk factor (HR 4.30, 95% CI 1.16-15.94; P = 0.0294), while overall disease duration failed to reach statistical significance (> 10 years: HR 1.91, 95% CI 0.64-5.69; P = 0.2466). The associations between development of AML/MDS and high count of WBC and low cholesterol levels suggest that these parameters could represent early markers of progression. Exposure to P32, busulphan and pipobroman (HR 5.46, 95% CI 1.84-16.25; P = 0.0023), but not to hydroxyurea (HU) alone (HR 0.86, 95% CI 0.26-2.88; P = 0.8021) had an independent role in producing an excess risk of progression to AML/MDS as compared to patients treated only with phlebotomy or interferon. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. Thiele Philadelphia Chromosome-Negative Chronic Myeloproliferative Disease Am J Clin Pathol, August 1, 2009; 132(2): 261 - 280. [Abstract] [Full Text] [PDF] A. 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