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008			230703b xxu||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_91206 _aAyala Díaz, Rosa María _eHematología y Hemoterapia
245	0	0	_aAntiplatelet therapy versus observation in low-risk essential thrombocythemia with a CALR mutation. _h[artículo]
260			_bHaematologica, _c2016
300			_a101(8):926-31.
500			_aFormato Vancouver: Alvarez Larrán A, Pereira A, Guglielmelli P, Hernández Boluda JC, Arellano Rodrigo E, Ferrer Marín F et al. Antiplatelet therapy versus observation in low-risk essential thrombocythemia with a CALR mutation. Haematologica. 2016 Aug;101(8):926-31.
501			_aPMID: 27175028 PMC4967571
504			_aContiene 18 referencias
520			_aThe role of antiplatelet therapy as primary prophylaxis of thrombosis in low-risk essential thrombocythemia has not been studied in randomized clinical trials. We assessed the benefit/risk of low-dose aspirin in 433 patients with low-risk essential thrombocythemia (271 with a CALR mutation, 162 with a JAK2(V617F) mutation) who were on antiplatelet therapy or observation only. After a follow up of 2215 person-years free from cytoreduction, 25 thrombotic and 17 bleeding episodes were recorded. In CALR-mutated patients, antiplatelet therapy did not affect the risk of thrombosis but was associated with a higher incidence of bleeding (12.9 versus 1.8 episodes per 1000 patient-years, P=0.03). In JAK2(V617F)-mutated patients, low-dose aspirin was associated with a reduced incidence of venous thrombosis with no effect on the risk of bleeding. Coexistence of JAK2(V617F)-mutation and cardiovascular risk factors increased the risk of thrombosis, even after adjusting for treatment with low-dose aspirin (incidence rate ratio: 9.8; 95% confidence interval: 2.3-42.3; P=0.02). Time free from cytoreduction was significantly shorter in CALR-mutated patients with essential thrombocythemia than in JAK2(V617F)-mutated ones (median time 5 years and 9.8 years, respectively; P=0.0002) and cytoreduction was usually necessary to control extreme thrombocytosis. In conclusion, in patients with low-risk, CALR-mutated essential thrombocythemia, low-dose aspirin does not reduce the risk of thrombosis and may increase the risk of bleeding.
710			_9297 _aServicio de Hematología y Hemoterapia
856			_uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967571/pdf/1010926.pdf _yAcceso libre
942			_2ddc _cART _n0