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Polycythemia vera: gender-related phenotypic differences

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Abstract

In polycythemia vera, gender has recently been shown to influence the JAK2V617F allele burden, but its effect on the disease phenotype is unknown. This issue was investigated using the database of the European Collaboration on Low-dose Aspirin in Polycythemia Vera (ECLAP) Study. The ECLAP Study recruited 1,638 polycythemic subjects and followed for 2.7 ± 1.3 years. At study entry, men, compared to women, had a higher prevalence of myocardial infarction (11.3 vs. 5.8%; P < 0.0001) and peripheral arterial disease (6.1 vs. 2.9%; P < 0.05) while a history of venous thrombosis was more common in women (11.4 vs. 7.9%, P = 0.016). Among 234 venous thrombosis, there were 39 splanchnic vein thromboses (33 extra-hepatic portal vein thromboses and 6 Budd-Chiari syndromes). Most of these events occurred as an early disease presentation in young female subjects. Women, compared to men, had higher platelet counts (average value 430 ± 213 vs. 375 ± 201 × 109/L; P < 0.0001) and lower hematocrits (0.46 ± 0.06 vs. 0.48 ± 0.06 l/l; P < 0.0001). Cholesterol plasma level, available in 995 subjects (61%), was lower in male patients (180.8 ± 43.1vs. 196 ± 46.6 mg/dl; P < 0.0001). During follow-up there were 205 major thromboses confirming an high incidence of myocardial infarction in men although not statistically significant (1.2 vs. 0.6 cases per 100 person-years; P > 0.05). These data show several gender-related differences both in the thrombotic diathesis and in the prevalence of vascular risk factors of PV patients.

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Acknowledgments

The contribution of TizianoBarbui, Raimondo De Cristofaro and Luca Miele to data interpretation and discussion is gratefully acknowledged.

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Authors and Affiliations

  1. Institute of Internal Medicine and Geriatrics, Haemostasis Research Center, Catholic University School of Medicine, Largo AgostinoGemelli 8, 00168, Rome, Italy

    Raffaele Landolfi, Leonardo Di Gennaro, Maria Anna Nicolazzi & Igor Giarretta

  2. Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario NegriSud, Santa Maria Imbaro, Italy

    RosaMaria Marfisi & Roberto Marchioli

Authors
  1. Raffaele Landolfi
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  2. Leonardo Di Gennaro
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  3. Maria Anna Nicolazzi
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  4. Igor Giarretta
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  5. RosaMaria Marfisi
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  6. Roberto Marchioli
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Corresponding author

Correspondence to Raffaele Landolfi.

Additional information

On behalf of the ECLAP Investigators.

The ECLAP Investigators are listed in Ref. [14].

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Landolfi, R., Di Gennaro, L., Nicolazzi, M.A. et al. Polycythemia vera: gender-related phenotypic differences. Intern Emerg Med 7, 509–515 (2012). https://doi.org/10.1007/s11739-011-0634-3

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  • DOI: https://doi.org/10.1007/s11739-011-0634-3

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