Clinical Analysis Of 96 Patients With Myeloproliferative Neoplasm

Objective:Summarize the clinical features of patients with Polycythemia vera(PV), Essential thrombocythemia(ET) or Primary myelofibrosis(PMF) in our center, which are classic BCR-ABL negative myeloproliferative neoplasms; analyze the risk factors of major complications of patients with PV and ET, as well as risk factors of survival of patients with PMF; explore a more suitable prognostic scoring system for the patients with myeloproliferative neoplasm in our center. Method:The clinical and laboratory test data of 96 newly diagnosed patients with PV, ET or PMF from 2000-2014 were collected. A retrospective analysis was carried out to analyze clinical manifestations, laboratory test data, disease outcome of patients and the effectiveness of treatment. Analyses of the risk factors of thrombosis and bleeding in patients with PV and ET were conducted by Fisher's exact test and logistic regression. Analyses of the survival of PMF patients were conducted by Kaplan-Meier method and COX regression. Compare the survival data estimated by five prognostic systems (LILLI, IPSS, DIPSS, modified IPSS and modified DIPSS) of PMF patients. Results:Platelet count was related to thrombosis in patients with PV according to both univariate analyses (p=0.013) and multivariate analysis(p=0.004, HR=1.009). Vascular risk factors B (diabetes with or with out hypertension, hyperlipidemia with or without hypertension) and thrombosis history were related to thrombosis in patients with ET according to univariate analyses, whereas vascular risk factors A (diabetes, hypertension, hyperlipidemia) is not; vascular risk factors B (p=0.023,OR=11.33) and thrombosis history(p=0.023,OR=9.76) were related to thrombosis in ET patients according to multivariate analysis. Constitutional symptoms, splenomegaly (?8cm below coastal margin), Hb<100g/L, PLT<100×109/L, LDH?440IU/L were related to poor survival according to univariate analyses, while constitutional symptoms (p=0.038, OR=3.55) and PLT<100×109/L(p=0.042, OR=2.89) were related to poor survival by multivariate analysis. Conclusion:Increased platelet count is independent risk factor of patients with PV. Vascular risk factors and thrombosis history are independent risk factors of thrombosis in patients with ET. Constitutional symptoms and PLT<100x109/L are independent risk factors for survival. LILLI, modified IPSS and modified DIPSS are suitable to patients in our center.