دورية أكاديمية
أعرض في EDS

A comparison between erythrocytapheresis and venesection for the treatment of JAK2-mutated polycythaemia.

التفاصيل البيبلوغرافية
العنوان: A comparison between erythrocytapheresis and venesection for the treatment of JAK2-mutated polycythaemia.
المؤلفون: Ngo TQ; Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia., Scott MW; Geelong Clinical School, Deakin University, Geelong, Victoria, Australia., Sirdesai S; Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia., Hempton JL; Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia., Hodges GS; Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia., Campbell PJ; Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia.; Geelong Clinical School, Deakin University, Geelong, Victoria, Australia.
المصدر: Internal medicine journal [Intern Med J] 2024 Jun; Vol. 54 (6), pp. 909-915. Date of Electronic Publication: 2023 Dec 25.
نوع المنشور: Journal Article; Comparative Study
اللغة: English
بيانات الدورية: Publisher: Blackwell Science Asia Country of Publication: Australia NLM ID: 101092952 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1445-5994 (Electronic) Linking ISSN: 14440903 NLM ISO Abbreviation: Intern Med J Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Carlton, Vic. : Blackwell Science Asia, c2001-
مواضيع طبية MeSH: Polycythemia Vera*/therapy , Janus Kinase 2*/genetics, Humans ; Male ; Female ; Middle Aged ; Aged ; Hematocrit ; Phlebotomy/methods ; Adult ; Mutation ; Retrospective Studies ; Cytapheresis/methods ; Treatment Outcome ; Thrombosis ; Polycythemia/therapy
مستخلص: Background: JAK2-mutated polycythaemia vera (PV) is associated with reduced survival because of thrombotic events and haematological disease transformation. Therapeutic venesection has traditionally been used to lower haematocrit, but the technique of erythrocytapheresis has emerged over the last decade.
Aim: To compare erythrocytapheresis with venesection as treatment for PV by assessing medical efficacy and financial viability.
Methods: One hundred sixteen patients with PV who received red cell depletion therapy at Barwon Health between 2014 and 2021 were identified. The haematocrit drop after each session, interval between treatment times and number of sessions required to achieve a haematocrit <0.45 were compared with an independent t test. Thrombosis rates were compared with Pearson's chi-squared test. Cost-funding analysis was done by assessing the Weighted Inlier Equivalent Separation and National Weighted Activity Unit funding models.
Results: Patients treated with erythrocytapheresis achieved a greater haematocrit drop each treatment session (0.075 vs 0.03, P < 0.01), required fewer sessions to achieve a haematocrit <0.45 (1 vs 4, P < 0.01) and experienced fewer thrombotic complications (8.7% vs 32.1%, P = 0.02) than those treated with venesection. Cost-funding analysis demonstrated that erythrocytapheresis was more financially viable with a surplus of AU$297 per session compared to a deficit of AU$176 with venesection. Even if funding for venesection is increased, the cost of erythrocytapheresis may be mitigated by a lower number of procedures required per year (3.8 vs 5.3, P < 0.01).
Conclusions: Erythrocytapheresis is more efficacious than venesection for the treatment of PV and is accompanied by rapid reductions in haematocrit and reduced thrombotic complications.
(© 2023 Royal Australasian College of Physicians.)
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فهرسة مساهمة: Keywords: JAK2; erythrocytapheresis; polycythaemia; venesection
المشرفين على المادة: EC 2.7.10.2 (Janus Kinase 2)
EC 2.7.10.2 (JAK2 protein, human)
تواريخ الأحداث: Date Created: 20231225 Date Completed: 20240617 Latest Revision: 20240617
رمز التحديث: 20240617
DOI: 10.1111/imj.16313
PMID: 38145421
قاعدة البيانات: MEDLINE
الوصف
تدمد:1445-5994
DOI:10.1111/imj.16313