{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T18:20:15Z","timestamp":1782584415571,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T00:00:00Z","timestamp":1722038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>International societies have conflicting recommendations on whether bone marrow aspirate\/biopsy (BMB) is needed during workup for isolated thrombocytopenia. Our objective was to determine if thrombocytopenia in patients aged \u226560\u2009years is associated with an increased incidence of haematological malignancy. We performed a retrospective population\u2010based cohort study in patients aged \u226560\u2009years between January 1, 2009 to December 31, 2019. Exposed patients had specialist consultation for thrombocytopenia, with platelet count &lt;100\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L, but normal haemoglobin and white blood cell count. Unexposed patients were those who never had specialist consultation for thrombocytopenia and whose platelets were \u2265100\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L. The primary outcome was the diagnosis of haematological malignancy using a competing risk of death model. During 4.0\u2009years (IQR 2.2\u20136.7) of follow\u2010up, 378\/4930 exposed (19.1\/1000PY, 95% CI 17.1\u201321.0), and 204\/17556 unexposed patients (2.5\/1000PY, 95% CI 2.2\u20132.8) were diagnosed with haematological malignancy (HR 15.5 (95% CI 11.3\u201321.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) in year 1, and 5.3 (95% CI 4.4\u20136.6, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) in years 2+). This finding persisted in analyses stratified by sex, age, severity, or duration of thrombocytopenia, and treatment with corticosteroids within 2\u2009weeks of consultation. This study found a strong association between isolated thrombocytopenia and haematological malignancy in patients \u226560\u2009years, supporting consideration of diagnostic testing including BMB during outpatient specialist consultation.<\/jats:p>","DOI":"10.1111\/bjh.19649","type":"journal-article","created":{"date-parts":[[2024,7,27]],"date-time":"2024-07-27T19:25:27Z","timestamp":1722108327000},"page":"1126-1136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Increased risk of haematological malignancy in adults over age 60 with thrombocytopenia compared with matched controls: Time for an upfront bone marrow evaluation?"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5369-1501","authenticated-orcid":false,"given":"A.","family":"Vijenthira","sequence":"first","affiliation":[{"name":"Division of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S.","family":"Wilton","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology Unity Health  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. H.","family":"Tang","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology Unity Health  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Gomes","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"},{"name":"Li Ka Shing Knowledge Institute  Toronto Ontario Canada"},{"name":"Leslie Dan Faculty of Pharmacy University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2884-9247","authenticated-orcid":false,"given":"J. B.","family":"Bussel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Weill Cornell Medical College  New York New York City USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sholzberg","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology Unity Health  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation.V2012.1.191.3798260"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V94.3.909.415k02_909_913"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-016-0780-z"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-08-302984"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/107602960200800110"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2257.2000.00340.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1999.tb140321.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04131.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-06-225565"},{"key":"e_1_2_12_11_1","unstructured":"Medical Council of Canada.Clinical laboratory tests\u2014Adult normal values. [Cited 2022 March 22]https:\/\/mcc.ca\/objectives\/normal\u2010values\/"},{"key":"e_1_2_12_12_1","unstructured":"Waiting Your Turn.Wait Times for Health Care in Canada.2022Report 2022; Available from:https:\/\/www.fraserinstitute.org\/sites\/default\/files\/waiting\u2010your\u2010turn\u20102022.pdf"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2016.0169"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2020.0047"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-020-01018-6"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071532"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2018.1489720"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-03-420489"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.022178"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-015-0533-2"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001654"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.248955"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.19649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T13:50:07Z","timestamp":1729691407000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.19649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,27]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/bjh.19649"],"URL":"https:\/\/doi.org\/10.1111\/bjh.19649","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,27]]},"assertion":[{"value":"2024-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}