Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative Neoplasms
Thrombotic and hemorrhagic complications are related to a significant rate of morbidity and mortality in patients with myeloproliferative neoplasms (MPNs), they are therefore called “thrombohemorrhagic” syndromes. Several clinical factors, such as age and presence of cardiovascular comorbidities are...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-06-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296221097969 |
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| author | Loula Papageorgiou Ismail Elalamy Patrick Vandreden Grigoris T Gerotziafas |
| author_facet | Loula Papageorgiou Ismail Elalamy Patrick Vandreden Grigoris T Gerotziafas |
| author_sort | Loula Papageorgiou |
| collection | DOAJ |
| description | Thrombotic and hemorrhagic complications are related to a significant rate of morbidity and mortality in patients with myeloproliferative neoplasms (MPNs), they are therefore called “thrombohemorrhagic” syndromes. Several clinical factors, such as age and presence of cardiovascular comorbidities are responsible for thrombotic complications. High blood counts, platelet alterations, presence of JAK2 mutation and possibly of other CHIP mutations such as TET2, DNMT3A, and ASXL1, procoagulant microparticles, NETs formation, endothelial activation and neo-angiogenesis are some of the parameters accounting for hypercoagulability in patients with myeloproliferative neoplasms. Bleeding complications emerge as a result of platelet exhaustion. They can be also linked to a functional deficiency of von Willebrand factor, when platelet counts rise above 1000G/L. The mainstay of management consists on preventing hemostatic complications, by antiplatelet and/or anticoagulant treatment and myelosuppressive agents in high-risk patients.Circumstances related to a high thrombohemorrhagic risk, such as pregnancy and the perioperative period, prompt for specific management with regards to anticoagulation and myelosuppression treatment type. In order to apply a patient-specific treatment strategy, there is a need for a risk score assessment tool encompassing clinical parameters and hemostasis biomarkers. |
| first_indexed | 2024-04-12T12:34:55Z |
| format | Article |
| id | doaj.art-19ccb8052c0e480fb29fd6e77431431b |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-04-12T12:34:55Z |
| publishDate | 2022-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-19ccb8052c0e480fb29fd6e77431431b2022-12-22T03:32:55ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232022-06-012810.1177/10760296221097969Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative NeoplasmsLoula Papageorgiou0Ismail Elalamy1Patrick Vandreden2Grigoris T Gerotziafas3 Faculty of Medicine, Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Sorbonne University, Paris, France The First I.M. Sechenov Moscow State Medical University, Moscow, Russia Clinical Research Department, Diagnostica Stago, Gennevilliers, France Faculty of Medicine, Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Sorbonne University, Paris, FranceThrombotic and hemorrhagic complications are related to a significant rate of morbidity and mortality in patients with myeloproliferative neoplasms (MPNs), they are therefore called “thrombohemorrhagic” syndromes. Several clinical factors, such as age and presence of cardiovascular comorbidities are responsible for thrombotic complications. High blood counts, platelet alterations, presence of JAK2 mutation and possibly of other CHIP mutations such as TET2, DNMT3A, and ASXL1, procoagulant microparticles, NETs formation, endothelial activation and neo-angiogenesis are some of the parameters accounting for hypercoagulability in patients with myeloproliferative neoplasms. Bleeding complications emerge as a result of platelet exhaustion. They can be also linked to a functional deficiency of von Willebrand factor, when platelet counts rise above 1000G/L. The mainstay of management consists on preventing hemostatic complications, by antiplatelet and/or anticoagulant treatment and myelosuppressive agents in high-risk patients.Circumstances related to a high thrombohemorrhagic risk, such as pregnancy and the perioperative period, prompt for specific management with regards to anticoagulation and myelosuppression treatment type. In order to apply a patient-specific treatment strategy, there is a need for a risk score assessment tool encompassing clinical parameters and hemostasis biomarkers.https://doi.org/10.1177/10760296221097969 |
| spellingShingle | Loula Papageorgiou Ismail Elalamy Patrick Vandreden Grigoris T Gerotziafas Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative Neoplasms Clinical and Applied Thrombosis/Hemostasis |
| title | Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative Neoplasms |
| title_full | Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative Neoplasms |
| title_fullStr | Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative Neoplasms |
| title_full_unstemmed | Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative Neoplasms |
| title_short | Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative Neoplasms |
| title_sort | thrombotic and hemorrhagic issues associated with myeloproliferative neoplasms |
| url | https://doi.org/10.1177/10760296221097969 |
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