TY  - JOUR
A1  - Kaifie, Andrea
A1  - Kirschner, Martin
A1  - Wolf, Dominik
A1  - Maintz, Christoph
A1  - Hänel, Mathias
A1  - Gattermann, Norbert
A1  - Gökkurt, Eray
A1  - Platzbecker, Uwe
A1  - Hollburg, Wiebke
A1  - Göthert, Joachim Rudolf
A1  - Parmentier, Stefani
A1  - Lang, Fabian
A1  - Hansen, Richard
A1  - Isfort, Susanne
A1  - Schmitt, Karla
A1  - Jost, Edgar
A1  - Serve, Hubert
A1  - Ehninger, Gerhard
A1  - Berdel, Wolfgang E.
A1  - Brümmendorf, Tim Henrik
A1  - Koschmieder, Steffen
T1  - Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN) : analysis from the German SAL-MPN-registry
T2  - Journal of hematology & oncology
N2  - 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.
KW  - MPN
KW  - PV
KW  - ET
KW  - PMF
KW  - MPN-U
KW  - Thrombosis
KW  - Thromboembolism
KW  - Major bleeding
KW  - Anticoagulation
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/44067
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-440675
SN  - 1756-8722
N1  - Copyright: © Kaifie et al. 2016. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
VL  - 9
IS  - Art. 18
SP  - 1
EP  - 11
PB  - Biomed Central
CY  - London
ER  -