Persistent leukocytosis in polycythemia vera is associated with disease evolution but not thrombosis

Lukas Ronner, Nikolai Podoltsev, Jason Gotlib, Mark L. Heaney, Andrew T. Kuykendall, Casey O'Connell, Jamile Shammo, Angela G. Fleischman, Robyn M. Scherber, Ruben Mesa, Abdulraheem Yacoub, Cecelia Perkins, Shelby Meckstroth, Lindsey Behlman, Matthew Chiaramonte, Mahta Salehi, Kimia Ziadkhanpour, Hellen Nguyen, Olivia Siwoski, Annie Kwok HungMichelle Janania Martinez, Jenny Nguyen, Sagar Patel, Revathi Kollipara, Ami Dave, Megan Randall, Michael Grant, Mitchell Harrison, Paola Fernandez Soto, Douglas Tremblay, Ronald Hoffman, Erin Moshier, John Mascarenhas

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

There are unresolved questions regarding the association between persistent leukocytosis and risk of thrombosis and disease evolution in polycythemia vera (PV), as much of the published literature on the topic does not appropriately use repeated-measures data or time-dependent modeling to answer these questions. To address this knowledge gap, we analyzed a retrospective database of 520 PV patients seen at 10 academic institutions across the United States. Taking hematologic laboratory data at ∼3-month intervals (or as available) for all patients for duration of follow-up, we used group-based trajectory modeling to identify latent clusters of patients who follow distinct trajectories with regard to their leukocyte, hematocrit, and platelet counts over time. We then tested the association between trajectory membership and hazard of 2 major outcomes: thrombosis and disease evolution to myelofibrosis, myelodysplastic syndrome, or acute myeloid leukemia. Controlling for relevant covariates, we found that persistently elevated leukocyte trajectories were not associated with the hazard of a thrombotic event (P 5.4163), but were significantly associated with increased hazard of disease evolution in an ascending stepwise manner (overall P 5.0002). In addition, we found that neither hematocrit nor platelet count was significantly associated with the hazard of thrombosis or disease evolution.

Original languageEnglish (US)
Pages (from-to)1696-1703
Number of pages8
JournalBlood
Volume135
Issue number19
DOIs
StatePublished - May 2020
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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