دورية أكاديمية
أعرض في EDS

Pregnancy outcomes, risk factors, and cell count trends in pregnant women with essential thrombocythemia.

التفاصيل البيبلوغرافية
العنوان: Pregnancy outcomes, risk factors, and cell count trends in pregnant women with essential thrombocythemia.
المؤلفون: How J; Department of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA; Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School Boston, MA, 02115, USA; Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA., Leiva O; Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA., Bogue T; Division of Hematology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115, USA., Fell GG; Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, 02115, USA., Bustoros MW; Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School Boston, MA, 02115, USA., Connell NT; Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School Boston, MA, 02115, USA; Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA., Connors JM; Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School Boston, MA, 02115, USA; Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA., Ghobrial IM; Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School Boston, MA, 02115, USA., Kuter DJ; Hematology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA., Mullally A; Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School Boston, MA, 02115, USA; Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA., Neuberg D; Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, 02115, USA., Zwicker JI; Division of Hematology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115, USA., Fogerty AE; Hematology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA., Hobbs GS; Department of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. Electronic address: ghobbs@partners.org.
المصدر: Leukemia research [Leuk Res] 2020 Nov; Vol. 98, pp. 106459. Date of Electronic Publication: 2020 Sep 29.
نوع المنشور: Clinical Trial; Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Pergamon Press Country of Publication: England NLM ID: 7706787 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-5835 (Electronic) Linking ISSN: 01452126 NLM ISO Abbreviation: Leuk Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford ; New York : Pergamon Press
مواضيع طبية MeSH: Abortion, Spontaneous* , Live Birth* , Models, Biological* , Pregnancy Complications, Hematologic*/blood , Pregnancy Complications, Hematologic*/drug therapy , Pregnancy Complications, Hematologic*/epidemiology , Thrombocythemia, Essential*/blood , Thrombocythemia, Essential*/drug therapy , Thrombocythemia, Essential*/epidemiology, Adult ; Female ; Humans ; Platelet Count ; Pregnancy ; Risk Factors
مستخلص: Pregnancy in essential thrombocythemia (ET) is associated with increased risk of obstetric complications. We retrospectively evaluated risk factors in 121 pregnancies in 52 ET women seen at 3 affiliate hospitals. Univariable and multivariable analyses were performed at the α = 0.10 level. Cell counts were characterized throughout pregnancy and correlated with outcomes using logistic modeling. The overall live birth rate was 69 %. 48.7 % of all women experienced a pregnancy complication, the most common being spontaneous abortion, which occurred in 26 % of all pregnancies. Maternal thrombosis and hemorrhage rates were 2.5 % and 5.8 %. On multivariable analysis, aspirin use (OR 0.29, p = 0.014, 90 % CI 0.118-0.658) and history of prior pregnancy loss (OR 3.86, p = 0.011, CI 1.49-9.15) were associated with decreased and increased pregnancy complications, respectively. A Markov model was used to analyze the probability of a future pregnancy complication based on initial pregnancy outcome. An ET woman who suffers a pregnancy complication has a 0.594 probability of a subsequent pregnancy complication, compared to a 0.367 probability if she didn't suffer a complication. However, despite this elevated risk, overall prognosis is good, with a >50 % probability of a successful pregnancy by the third attempt. Platelet counts decreased by 43 % in ET during pregnancy, with nadir at delivery and prompt recovery in the postpartum period. Women with larger declines in gestational platelet counts were less likely to suffer complications (p = 0.083). Our study provides important guidance to physicians treating ET women during pregnancy, including counseling information regarding risk assessment and expected trajectory of platelet levels.
(Copyright © 2020. Published by Elsevier Ltd.)
التعليقات: Comment in: Leuk Res. 2021 Mar;102:106500. (PMID: 33556743)
فهرسة مساهمة: Keywords: Essential thrombocythemia; Gestational cell counts; Myeloproliferative neoplasm; Polycythemia vera; Pregnancy
تواريخ الأحداث: Date Created: 20201006 Date Completed: 20210118 Latest Revision: 20210416
رمز التحديث: 20231215
DOI: 10.1016/j.leukres.2020.106459
PMID: 33022566
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-5835
DOI:10.1016/j.leukres.2020.106459