by David Wallace
Summary:
Researchers have developed a new Essential Thrombocythemia scoring system called the “triple A” (AAA) model to predict outcomes in patients with essential thrombocythemia (ET), a type of blood cancer. This model uses three simple factors: age, absolute neutrophil count, and absolute lymphocyte count to categorize patients into different risk groups.
The study found that this new Essential Thrombocythemia score can effectively predict not only overall survival but also the risk of blood clots and other complications in ET patients, potentially improving patient care and treatment decisions.
Key points:
Essential thrombocythemia (ET) is a blood cancer characterized by an overproduction of platelets, which can lead to complications like blood clots and bleeding.
The AAA Essential Thrombocythemia score uses age and two easily obtainable blood cell counts to classify patients into four risk groups: low, intermediate-1, intermediate-2, and high risk.
Higher risk groups were associated with:
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- Older age
- More cardiovascular risk factors, especially high blood pressure
- Higher chances of blood clots and major bleeding events
- Lower overall survival rates
The Essential Thrombocythemia score performed well in predicting:
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- Overall survival
- Thrombosis-free survival
- Major bleeding-free survival
- Global event-free survival (including thrombosis, bleeding, disease progression, and death)
The AAA Essential Thrombocythemia score was effective regardless of the specific genetic mutation (JAK2, CALR, or MPL) causing ET.
This new scoring system could be a simple and effective tool for doctors to quickly identify high-risk ET patients at their first medical referral.
The AAA Essential Thrombocythemia score may be used alongside existing risk assessment tools like IPSET-t and r-IPSET-t to improve patient care in ET.
The study validated the AAA model’s effectiveness in a cohort of 314 ET patients from a single center.
While promising, the study has some limitations due to its retrospective nature and relatively small sample size compared to the original validation cohorts.
Conclusion:
The AAA Essential Thrombocythemia score represents a significant advancement in risk assessment for essential thrombocythemia patients. By using readily available clinical information, it provides a comprehensive view of patient risk, encompassing not just overall survival but also the likelihood of thrombotic events and major bleeding.
This holistic approach to risk stratification could lead to more personalized treatment strategies and improved patient outcomes. As with any new medical tool, further studies with larger patient populations will be necessary to fully establish its utility in clinical practice. Nonetheless, the AAA Essential Thrombocythemia score shows great promise in enhancing the care of ET patients by offering a simple yet effective method for identifying those at highest risk of adverse outcomes.
You can find more information on the scoring model here and more information on ET: 2024 update on diagnosis, risk stratification and management (abstract only).
Reference:
Tosoni, L., Morelli, G. L., Tomadini, G., Lazzarotto, D., Filì, C., Simeone, E., … & Tiribelli, M. (2024). The triple A (AAA) model globally recapitulates adverse outcomes in essential thrombocythemia. Blood Cancer Journal, 14(1), 169. https://doi.org/10.1038/s41408-024-01151-2
