{"title":"加强在初级保健机构再生障碍性贫血的检测：在意大利的一项基于人群的研究。","authors":"Francesco Lapi, Ettore Marconi, Iacopo Cricelli, Adriana Masotti, Alessandro Rossi, Claudio Cricelli","doi":"10.1080/17474086.2025.2500604","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Aplastic Anemia (AA) is a rare, life-threatening condition featured by hypocellular bone marrow without leukemia or myelodysplastic syndromes. Early diagnosis is vital because of the effectiveness of the existing treatments. This study examined AA epidemiology and clinical correlates to aid general practitioners (GPs) in recognizing potential AA cases.</p><p><strong>Research design and methods: </strong>The Italian Health Search database (HSD) was used. A cohort study on individuals aged 18 years and older registered in the HSD between 1 January 1998, and 31 December 2022, estimated the prevalence and incidence rate of AA. Cases were operationally classified as 'certain,' 'probable,' and 'possible.' A case-control study was conducted to examine the clinical correlates of AA.</p><p><strong>Results: </strong>The cumulative prevalence was 3.8-4.8 per 100,000. The AA incidence rates for certain, certain/probable, and certain/probable/possible diagnoses were 0.3, 0.7, and 6 cases/million person-years, respectively. Increased infections (OR = 2.5), higher comorbidity burden (Charlson Index 1: OR = 2.14; 2+: OR = 2.43), and immunosuppressants use (OR = 14.9) were strongly associated with an AA diagnosis.</p><p><strong>Conclusions: </strong>Our findings indicate that AA is often underdiagnosed in primary care, but these data could help raise the suspicion of AA. Efforts are needed to utilize GPs' healthcare records for early AA identification and to enhance GP-hematologist collaboration.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"1-7"},"PeriodicalIF":2.3000,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"To enhance the detection of aplastic anemia in primary care settings: a population-based study in Italy.\",\"authors\":\"Francesco Lapi, Ettore Marconi, Iacopo Cricelli, Adriana Masotti, Alessandro Rossi, Claudio Cricelli\",\"doi\":\"10.1080/17474086.2025.2500604\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Aplastic Anemia (AA) is a rare, life-threatening condition featured by hypocellular bone marrow without leukemia or myelodysplastic syndromes. Early diagnosis is vital because of the effectiveness of the existing treatments. This study examined AA epidemiology and clinical correlates to aid general practitioners (GPs) in recognizing potential AA cases.</p><p><strong>Research design and methods: </strong>The Italian Health Search database (HSD) was used. A cohort study on individuals aged 18 years and older registered in the HSD between 1 January 1998, and 31 December 2022, estimated the prevalence and incidence rate of AA. Cases were operationally classified as 'certain,' 'probable,' and 'possible.' A case-control study was conducted to examine the clinical correlates of AA.</p><p><strong>Results: </strong>The cumulative prevalence was 3.8-4.8 per 100,000. The AA incidence rates for certain, certain/probable, and certain/probable/possible diagnoses were 0.3, 0.7, and 6 cases/million person-years, respectively. Increased infections (OR = 2.5), higher comorbidity burden (Charlson Index 1: OR = 2.14; 2+: OR = 2.43), and immunosuppressants use (OR = 14.9) were strongly associated with an AA diagnosis.</p><p><strong>Conclusions: </strong>Our findings indicate that AA is often underdiagnosed in primary care, but these data could help raise the suspicion of AA. Efforts are needed to utilize GPs' healthcare records for early AA identification and to enhance GP-hematologist collaboration.</p>\",\"PeriodicalId\":12325,\"journal\":{\"name\":\"Expert Review of Hematology\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-05-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Hematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/17474086.2025.2500604\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17474086.2025.2500604","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
To enhance the detection of aplastic anemia in primary care settings: a population-based study in Italy.
Background: Aplastic Anemia (AA) is a rare, life-threatening condition featured by hypocellular bone marrow without leukemia or myelodysplastic syndromes. Early diagnosis is vital because of the effectiveness of the existing treatments. This study examined AA epidemiology and clinical correlates to aid general practitioners (GPs) in recognizing potential AA cases.
Research design and methods: The Italian Health Search database (HSD) was used. A cohort study on individuals aged 18 years and older registered in the HSD between 1 January 1998, and 31 December 2022, estimated the prevalence and incidence rate of AA. Cases were operationally classified as 'certain,' 'probable,' and 'possible.' A case-control study was conducted to examine the clinical correlates of AA.
Results: The cumulative prevalence was 3.8-4.8 per 100,000. The AA incidence rates for certain, certain/probable, and certain/probable/possible diagnoses were 0.3, 0.7, and 6 cases/million person-years, respectively. Increased infections (OR = 2.5), higher comorbidity burden (Charlson Index 1: OR = 2.14; 2+: OR = 2.43), and immunosuppressants use (OR = 14.9) were strongly associated with an AA diagnosis.
Conclusions: Our findings indicate that AA is often underdiagnosed in primary care, but these data could help raise the suspicion of AA. Efforts are needed to utilize GPs' healthcare records for early AA identification and to enhance GP-hematologist collaboration.
期刊介绍：
Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.
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