de Graaf, Aniek O

Diepstra, Arjan

Huls, Gerwin

Jansen, Joop H

Malcovati, Luca

Schuringa, Jan Jacob

van der Klauw, Melanie M

van der Reijden, Bert A

van Zeventer, Isabelle A

Vellenga, Edo

English

University of Groningen

Peripheral blood cytopenias in the aging general population and risk of incident hematological disease and mortality

Peripheral blood cytopenias may precede the development of hematological malignancies and frequently pose clinical challenges in the older population. The natural course of (mild) cytopenias during aging and their association with hematological disorders in community-dwelling individuals are not well studied. Within the population-based Lifelines cohort (n = 167 729), we studied changes in peripheral blood counts, occurrence of cytopenias, and associated hematological outcomes in the context of aging. Development of hematological malignancies and (cause-specific) mortality were evaluated by linkage to nationwide registries. Anemia and thrombocytopenia emerged with older age, in line with a general age-related decline in these blood counts. For neutropenia, no increase in prevalence with older age was observed. Using standard reference limits to define cytopenias, anemia (hazard ratio [HR], 1.84; 95% confidence interval [CI], 1.59-2.12), thrombocytopenia (HR, 1.58; 95% CI, 1.32-1.89), and, especially the concomitant presence of anemia and thrombocytopenia (HR, 4.75; 95% CI, 2.98-7.55) were associated with inferior overall survival. Only a minor proportion of deaths was explained by diagnosed hematological malignancies, with the majority attributable to other causes. Neutropenia, either isolated (HR, 0.88; 95% CI, 0.73-1.06) or combined with another cytopenia, did not affect overall survival. For individuals aged 60 years, 5-year cumulative incidence of hematological malignancies was &gt;= 60% (95% CI, 0.50-0.70), with higher incidences among those with anemia (P &lt; .001) or thrombocytopenia (P &lt; .001) but not neutropenia (P = .201). Highest cumulative incidences of diagnoses and mortality from hematological malignancies were observed in individuals with &gt;1 cytopenia. We conclude that anemia and thrombocytopenia, but not neutropenia, are associated with inferior overall survival of community-dwelling individuals. Hematological malignancies develop in a small fraction of these cases.</p

Dissertations of the University of Groningen

Peripheral blood cytopenias may precede the development of hematological malignancies and frequently pose clinical challenges in the older population. The natural course of (mild) cytopenias during aging and their association with hematological disorders in community-dwelling individuals are not well studied. Within the population-based Lifelines cohort (n = 167 729), we studied changes in peripheral blood counts, occurrence of cytopenias, and associated hematological outcomes in the context of aging. Development of hematological malignancies and (cause-specific) mortality were evaluated by linkage to nationwide registries. Anemia and thrombocytopenia emerged with older age, in line with a general age-related decline in these blood counts. For neutropenia, no increase in prevalence with older age was observed. Using standard reference limits to define cytopenias, anemia (hazard ratio [HR], 1.84; 95% confidence interval [CI], 1.59-2.12), thrombocytopenia (HR, 1.58; 95% CI, 1.32-1.89), and, especially the concomitant presence of anemia and thrombocytopenia (HR, 4.75; 95% CI, 2.98-7.55) were associated with inferior overall survival. Only a minor proportion of deaths was explained by diagnosed hematological malignancies, with the majority attributable to other causes. Neutropenia, either isolated (HR, 0.88; 95% CI, 0.73-1.06) or combined with another cytopenia, did not affect overall survival. For individuals aged 60 years, 5-year cumulative incidence of hematological malignancies was >= 60% (95% CI, 0.50-0.70), with higher incidences among those with anemia (P 1 cytopenia. We conclude that anemia and thrombocytopenia, but not neutropenia, are associated with inferior overall survival of community-dwelling individuals. Hematological malignancies develop in a small fraction of these cases

NARCIS 

ARTS repository - University of Groningen

Archivio Istituzionale della Ricerca - Università degli Studi di Pavia

Zeventer, Isabelle A. van

Graaf, A.O. de

Klauw, Melanie M. van der

Reijden, B.A. van der

Jansen, J.H.

Huls, G.A.

Radboud Repository

Proceedings - University of Groningen

https://pure.rug.nl/ws/files/180052238/advancesadv2021004355.pdf

Peripheral blood cytopenias in the aging general population and risk of incident hematological disease and mortality

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University of Groningen

Dissertations of the University of Groningen

NARCIS

ARTS repository - University of Groningen

Archivio Istituzionale della Ricerca - Università degli Studi di Pavia

University of Groningen

Radboud Repository

Dissertations of the University of Groningen

Proceedings - University of Groningen

Proceedings - University of Groningen