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Study of bone metabolism and angiogenesis in patients undergoing high‐dose chemotherapy/autologous hematopoietic stem cell transplantation |
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| Authors: | Georgios Boutsikas Evangelos Terpos Athanasios Papatheodorou Pantelis Tsirkinidis Panayiotis Tsirigotis Anastasia Meletiou Eleni Lalou Vasileios Telonis Anna Zannou Alexander Kanellopoulos Zacharoula Galani Angeliki Stefanou Panayiotis Tsaftaridis Nora‐Athina Viniou Panayiotis Panayiotidis Marie‐Christine Kyrtsonis John Meletis Theodoros P. Vassilakopoulos Maria K. Angelopoulou |
| Affiliation: | 1. Department of Hematology and Bone Marrow Transplantation Unit, National and Kapodistrian University of Athens, Athens, Greece;2. Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece;3. Department of Biomedical Research, 251 Air Force General Hospital of Athens, Athens, Greece;4. Department of Hematology, 401 Army General Hospital of Athens, Athens, Greece;5. 2nd Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece;6. 1st Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece;7. 1st Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece |
| Abstract: | ObjectivesRisk of thrombosis is significantly enhanced by both elevated platelet (PLT) and white blood cell (WBC) counts according to a retrospective analysis of a large anagrelide registry in thrombocythemic MPN patients. We were interested in the impact of elevated WBC counts on thrombosis risk in patients where PLT counts were reduced below the calculated cutoff of 574.5 G/L by treatment with anagrelide.MethodsCox regression analysis and Kaplan‐Meier plot were applied on all patients in the registry with optimized PLT counts.ResultsUsing the calculated cutoff of 9.66 G/L for WBC, Cox regression analysis revealed a clear influence of elevated WBC counts on the occurrence of a major thrombotic event (P = .012). A Kaplan‐Meier plot revealed a markedly shorter time to a major thrombotic event for patients with WBC counts above the cutoff (P = .001).ConclusionsThese data suggest that additional correction of elevated WBC counts is mandatory in patients with optimally managed PLT counts to reduce thrombotic risk. This study is the first investigation in a prospectively observed large patient cohort which was treated homogenously allowing for evaluation of single parameters for an effect on thrombophilia. |
| Keywords: | angiogenesis bone metabolism engraftment hematopoietic stem cell transplantation |