Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry
Abstract Background Patients with Ph-negative myeloproliferative neoplasms (MPN), such as polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are at increased risk for thrombosis/thromboembolism and major bleeding. Due to the morbidity and mortality of these even...
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BMC
2016-03-01
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| Series: | Journal of Hematology & Oncology |
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| Online Access: | http://link.springer.com/article/10.1186/s13045-016-0242-9 |
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| author | A. Kaifie M. Kirschner D. Wolf C. Maintz M. Hänel N. Gattermann E. Gökkurt U. Platzbecker W. Hollburg J. R. Göthert S. Parmentier F. Lang R. Hansen S. Isfort K. Schmitt E. Jost H. Serve G. Ehninger W. E. Berdel T. H. Brümmendorf S. Koschmieder for the Study Alliance Leukemia (SAL) |
| author_facet | A. Kaifie M. Kirschner D. Wolf C. Maintz M. Hänel N. Gattermann E. Gökkurt U. Platzbecker W. Hollburg J. R. Göthert S. Parmentier F. Lang R. Hansen S. Isfort K. Schmitt E. Jost H. Serve G. Ehninger W. E. Berdel T. H. Brümmendorf S. Koschmieder for the Study Alliance Leukemia (SAL) |
| author_sort | A. Kaifie |
| collection | DOAJ |
| description | Abstract Background Patients with Ph-negative myeloproliferative neoplasms (MPN), such as polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are at increased risk for thrombosis/thromboembolism and major bleeding. Due to the morbidity and mortality of these events, antiplatelet and/or anticoagulant agents are commonly employed as primary and/or secondary prophylaxis. On the other hand, disease-related bleeding complications (i.e., from esophageal varices) are common in patients with MPN. This analysis was performed to define the frequency of such events, identify risk factors, and assess antiplatelet/anticoagulant therapy in a cohort of patients with MPN. Methods The MPN registry of the Study Alliance Leukemia is a non-interventional prospective study including adult patients with an MPN according to WHO criteria (2008). For statistical analysis, descriptive methods and tests for significant differences as well as contingency tables were used to identify the odds of potential risk factors for vascular events. Results MPN subgroups significantly differed in sex distribution, age at diagnosis, blood counts, LDH levels, JAK2V617F positivity, and spleen size (length). While most thromboembolic events occurred around the time of MPN diagnosis, one third of these events occurred after that date. Splanchnic vein thrombosis was most frequent in post-PV-MF and MPN-U patients. The chance of developing a thromboembolic event was significantly elevated if patients suffered from post-PV-MF (OR 3.43; 95 % CI = 1.39–8.48) and splenomegaly (OR 1.76; 95 % CI = 1.15–2.71). Significant odds for major bleeding were previous thromboembolic events (OR = 2.71; 95 % CI = 1.36–5.40), splenomegaly (OR = 2.22; 95 % CI 1.01–4.89), and the administration of heparin (OR = 5.64; 95 % CI = 1.84–17.34). Major bleeding episodes were significantly less frequent in ET patients compared to other MPN subgroups. Conclusions Together, this report on an unselected “real-world” cohort of German MPN patients reveals important data on the prevalence, diagnosis, and treatment of thromboembolic and major bleeding complications of MPN. |
| first_indexed | 2024-12-10T06:00:42Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1756-8722 |
| language | English |
| last_indexed | 2024-12-10T06:00:42Z |
| publishDate | 2016-03-01 |
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| series | Journal of Hematology & Oncology |
| spelling | doaj.art-7b4f0f8e5f844fc8bcb6f9bd5fc11b252022-12-22T01:59:50ZengBMCJournal of Hematology & Oncology1756-87222016-03-019111110.1186/s13045-016-0242-9Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registryA. Kaifie0M. Kirschner1D. Wolf2C. Maintz3M. Hänel4N. Gattermann5E. Gökkurt6U. Platzbecker7W. Hollburg8J. R. Göthert9S. Parmentier10F. Lang11R. Hansen12S. Isfort13K. Schmitt14E. Jost15H. Serve16G. Ehninger17W. E. Berdel18T. H. Brümmendorf19S. Koschmieder20for the Study Alliance Leukemia (SAL)Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen UniversityDepartment of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen UniversityInternal Medicine 3, Oncology, Hematology and Rheumatology, University Clinic Bonn (UKB)Practice for Hematology and OncologyDepartment for Hematology, Oncology, Stem Cell Transplantation, Hospital ChemnitzDepartment for Hematology, Oncology and Clinical Immunology, University Hospital DuesseldorfPractice for Hematology-Oncology EppendorfDepartment for Hematology, University Hospital DresdenPractice for Hematology and Oncology AltonaDepartment for Hematology, University Hospital EssenDepartment for Hematology, Oncology and Palliative Care, Rems-Murr-HospitalsDepartment for Hematology and Oncology, University Hospital Frankfurt/MainPractice for Hematology and OncologyDepartment of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen UniversityDepartment of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen UniversityDepartment of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen UniversityDepartment for Hematology and Oncology, University Hospital Frankfurt/MainDepartment for Hematology, University Hospital DresdenDepartment of Medicine A, University Hospital MünsterDepartment of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen UniversityDepartment of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen UniversityAbstract Background Patients with Ph-negative myeloproliferative neoplasms (MPN), such as polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are at increased risk for thrombosis/thromboembolism and major bleeding. Due to the morbidity and mortality of these events, antiplatelet and/or anticoagulant agents are commonly employed as primary and/or secondary prophylaxis. On the other hand, disease-related bleeding complications (i.e., from esophageal varices) are common in patients with MPN. This analysis was performed to define the frequency of such events, identify risk factors, and assess antiplatelet/anticoagulant therapy in a cohort of patients with MPN. Methods The MPN registry of the Study Alliance Leukemia is a non-interventional prospective study including adult patients with an MPN according to WHO criteria (2008). For statistical analysis, descriptive methods and tests for significant differences as well as contingency tables were used to identify the odds of potential risk factors for vascular events. Results MPN subgroups significantly differed in sex distribution, age at diagnosis, blood counts, LDH levels, JAK2V617F positivity, and spleen size (length). While most thromboembolic events occurred around the time of MPN diagnosis, one third of these events occurred after that date. Splanchnic vein thrombosis was most frequent in post-PV-MF and MPN-U patients. The chance of developing a thromboembolic event was significantly elevated if patients suffered from post-PV-MF (OR 3.43; 95 % CI = 1.39–8.48) and splenomegaly (OR 1.76; 95 % CI = 1.15–2.71). Significant odds for major bleeding were previous thromboembolic events (OR = 2.71; 95 % CI = 1.36–5.40), splenomegaly (OR = 2.22; 95 % CI 1.01–4.89), and the administration of heparin (OR = 5.64; 95 % CI = 1.84–17.34). Major bleeding episodes were significantly less frequent in ET patients compared to other MPN subgroups. Conclusions Together, this report on an unselected “real-world” cohort of German MPN patients reveals important data on the prevalence, diagnosis, and treatment of thromboembolic and major bleeding complications of MPN.http://link.springer.com/article/10.1186/s13045-016-0242-9MPNPVETPMFMPN-UThrombosis |
| spellingShingle | A. Kaifie M. Kirschner D. Wolf C. Maintz M. Hänel N. Gattermann E. Gökkurt U. Platzbecker W. Hollburg J. R. Göthert S. Parmentier F. Lang R. Hansen S. Isfort K. Schmitt E. Jost H. Serve G. Ehninger W. E. Berdel T. H. Brümmendorf S. Koschmieder for the Study Alliance Leukemia (SAL) Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry Journal of Hematology & Oncology MPN PV ET PMF MPN-U Thrombosis |
| title | Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry |
| title_full | Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry |
| title_fullStr | Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry |
| title_full_unstemmed | Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry |
| title_short | Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry |
| title_sort | bleeding thrombosis and anticoagulation in myeloproliferative neoplasms mpn analysis from the german sal mpn registry |
| topic | MPN PV ET PMF MPN-U Thrombosis |
| url | http://link.springer.com/article/10.1186/s13045-016-0242-9 |
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