-Author name in bold denotes the presenting author
-Asterisk * with author name denotes a Non-ASH member
Clinically Relevant Abstract denotes an abstract that is clinically relevant.

PhD Trainee denotes that this is a recommended PHD Trainee Session.

Ticketed Session denotes that this is a ticketed session.

2821 Application of the International Prognostic Score of Thrombosis for Essential Thrombocytemia(ET) (IPSET-Thrombosis) in a Cohort of ET Patients: Experience from Gruppo Laziale for Myeloproliferative Ph Negative Neoplasms

Myeloproliferative Syndromes: Clinical
Program: Oral and Poster Abstracts
Session: 634. Myeloproliferative Syndromes: Clinical: Poster II
Sunday, December 6, 2015, 6:00 PM-8:00 PM
Hall A, Level 2 (Orange County Convention Center)

Michele Cedrone, MD1*, Barbara Anaclerico, MD2*, Francesca Paoloni, Dr3*, Roberto Latagliata, MD4*, Marco Montanaro, MD5*, Francesca Spirito6*, Sabrina Leonetti Crescenzi, MD7*, Antonio Spadea, MD8, Raffaele Porrini, MD9*, Angela Rago, MD10*, Massimo Breccia, MD11*, Cinzia De Gregoris12*, Giuseppe Cimino, MD13*, Enrico Montefusco, MD14*, Agostino Tafuri, MD15, Giuseppe Avvisati, MD16, Ignazio Majolino, MD17, Francesco Lo Coco, MD18*, Cristina Santoro, MD19*, Maria Gabriella Mazzucconi, MD20*, Carla Ruscio6*, Marianna De Muro, MD21*, Giuliana Alimena, MD22, Alessandro Andriani, MD23*, Antonino Bagnato24* and Luciana Annino25*

1UOC of Hematology, San Giovanni - Addolorata Hospital, Rome, Italy
2Hematology, San Giovanni - Addolorata Hospital, Rome, Italy
3GIMEMA, Rome, Italy
4Division of Hematology-Dept. of Cellular Biotechnologies and Hematology, University La Sapienza of Rome, Rome, Italy
5ASL VT, UOC of Hemathology, Viterbo, Italy
6UOC of Hematology and bone marrow transplantation, San Camillo-Forlanini Hospital, Rome, Italy
7UOC Haematology, San Giovanni - Addolorata Hospital, Rome, Italy
8Clinical Oncology, Istituto Regina Elena, Rome, Italy
9Hematology, Azienda Ospedaliera Sant'Andrea, Rome, Italy
10UOC of Hematology, University, Latina, Italy
11Dipartimento di Ematologia e Biotecnologie, Università La Sapienza, Rome, Italy
12UOC of Hematology, ASL VT, Viterbo, Italy
13S.M. Goretti, UOC Hematology, Latina, Italy
14Hematology Unity, Sant'Andrea Hospital, Rome, Italy
15Hematology, Sapienza AO Sant'Andrea, Rome, Italy
16Dept. of Hematology, University Campus Bio-Medico, Rome, Italy
17Ematologia, Ospedale S. Camillo, Rome, Italy
18Hematology, University Tor Vergata, Rome, Italy
19University of Rome “Sapienza”, Department of Cellular Biotechnologies and Hematology, Rome, Italy
20Centro Regionale di Riferimento per l’Emofilia e Sindromi Correlate, Università Sapienza, Policlinico Umberto I, Rome, Italy
21Hematology, Univ. Campus Bio Medieo, Rome, Italy
22Department of Biotechnologies and Hematology, Sapienza University, Rome, Italy
23UOSA of Hematology, ASL RMA, Nuovo Regina Margherita Hospital, Rome, Italy
24UOC Haematology, San Giovanni Hospital, Rome, Italy
25S.Giovanni-Addolorata Hospital, Rome, Italy

INTRODUCTION: Essential Thrombocytemia (ET) is the most common of the myeloproliferative neoplasms, vascular complications contribute mostly to both morbidity and mortality. The ability to identify thrombotic risk of the individual patient is necessary for a correct therapeutic management. Traditionally, risk stratification for thrombosis in ET pts  was based on the respective absence and/or presence of either age >60 years or history of thrombosis. Recently, the IPSET score  (International Prognostic Score Of Thrombosis for ET) was developed to better predict the occurrence of thrombotic events in ET patients. Risk factors included in the new score were: age, cardiovascular risk factors, previous thrombosis, presence of JAK 2 V617F mutation.

AIM: to evaluate  the validity of IPSET-thrombosis score in a cohort of ET patients from “Gruppo Laziale for Myeloproliferative Ph negative Neoplasms” in predicting thrombosis incidence.

METHODS: from January 1978 to December 2011 we observed 1249 ET patients, median follow up was 105 months (range 12.1-417.7). We were able to retrospectively evaluate all the IPSET risk factors in 680 ET patients  and estimated the clinical implication of the IPSET-thrombosis score system. According to the score 27.3 %, 19.1% and 53.5% of pts were stratified in low, intermediate and high risk group respectively.

RESULTS: median age at the time of diagnosis was 61.8  yrs (range 19.9 -94; 64% females),  median hemoglobin was 14 g/dl  (range 6-20); median leukocyte count was 8.8 x 109/L (range 1,2-57); median platelets count was 812x 109/L  (range 108-3582).  We observed, during a median follow-up of 200 months, 82 thrombotic events (total incidence 17,89 %). According IPSET-thrombosis risk, in our ET population was documented a statistically different thrombosis free survival (TFS) (Gray test 0.1316):  85%, 78%, 77% in low,intermediate  and  high risk group  respectively.  During all the observation period the intermediate and high risk group showed a similar probability of thrombotic events.

CONCLUSIONS: in our retrospective study the IPSET score was able to differentiate the rate of  thrombosis events in low-risk (0-1 risk factors) from that of intermediate (>= 2 risk factors) and  high risk (>= 3 risk factors) ET pts. Unfortunately the intermediate and high risk groups show a similar incidence of thrombotic events during  the whole observation period. We were not able to verify the clinical benefit resulting from the different treatment strategies. Because treatment options in ET pts are tailored according to thrombotic risk, and since we have specified  therapeutic indications for patients with low and high risk, it is necessary to validate the score IPSET in a large prospective, long term study to discriminate  a true “intermediate” subset of patients for which there are no currently defined therapeutic guidelines.

Disclosures: No relevant conflicts of interest to declare.

*signifies non-member of ASH