Splanchnic vein thrombosis in myeloproliferative neoplasms: risk factors for recurrences in a cohort of 181 patients

被引：87

作者：

De Stefano, V. ^{[1
]}

Vannucchi, A. M. ^{[2
]}

Ruggeri, M. ^{[3
]}

Cervantes, F. ^{[4
]}

Alvarez-Larran, A. ^{[5
]}

Iurlo, A. ^{[6
]}

Randi, M. L. ^{[7
]}

Pieri, L. ^{[2
]}

Rossi, E. ^{[1
]}

Guglielmelli, P. ^{[2
]}

Betti, S. ^{[1
]}

Elli, E. ^{[8
]}

Finazzi, M. C. ^{[9
]}

Finazzi, G. ^{[9
]}

Zetterberg, E. ^{[10
]}

Vianelli, N. ^{[11
]}

Gaidano, G. ^{[12
]}

Nichele, I. ^{[3
]}

Cattaneo, D. ^{[6
]}

Palova, M. ^{[13
]}

Ellis, M. H. ^{[14
]}

Cacciola, E. ^{[15
]}

Tieghi, A. ^{[16
]}

Hernandez-Boluda, J. C. ^{[17
]}

Pungolino, E. ^{[18
]}

Specchia, G. ^{[19
]}

Rapezzi, D. ^{[20
]}

Forcina, A. ^{[21
]}

Musolino, C. ^{[22
]}

Carobbio, A. ^{[23
]}

Griesshammer, M. ^{[24
]}

Barbui, T. ^{[23
]}

机构：

[1] Catholic Univ, Inst Hematol, Rome, Italy

[2] Univ Florence, AOU Careggi, Ctr Res & Innovat Myeloproliferat Neoplasms, Florence, Italy

[3] Ospedale San Bortolo, Vicenza, Italy

[4] Hosp Clin IDIBAPS, Barcelona, Spain

[5] Hosp del Mar, IMIM, Dept Hematol, Barcelona, Spain

[6] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Oncohematol Div, Milan, Italy

[7] Univ Padua, Clin Med 1, Padua, Italy

[8] Osped San Gerardo, ASST Monza, Div Ematol, Monza, Italy

[9] ASST Papa Giovanni XXIII, Div Hematol, Bergamo, Italy

[10] Skane Univ Hosp, Lund, Sweden

[11] Univ Bologna, S Orsola Malpighi Hosp, Inst Hematol & Med Oncol, Bologna, Italy

[12] Univ Piemonte Orientale, Dept Translat Med, Vercelli, Italy

[13] Univ Hosp Olomouc, Olomouc, Czech Republic

[14] Inst Meir Med Ctr, Dept Hematol, Kefar Sava, Israel

[15] Univ Catania, Dept Med Surg & Adv Technol Sci GF Ingrassia, Haemostasis Unit, Catania, Italy

[16] IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy

[17] Hosp Clin, Valencia, Spain

[18] AO Osped Niguarda Ca Granda, Milan, Italy

[19] AO Univ, Policlin Bari, Bari, Italy

[20] AO Santa Croce & Carle, Cuneo, Italy

[21] IRCCS Osped San Raffaele, Milan, Italy

[22] AO Univ, Messina, Italy

[23] ASST Papa Giovanni XXIII, FROM Res Fdn, Piazza OMS 1, I-24127 Bergamo, Italy

[24] Univ Bochum, Johannes Wesling Med Ctr Minden, Minden, Germany

来源：

BLOOD CANCER JOURNAL | 2016年 / 6卷

关键词：

BUDD-CHIARI-SYNDROME; TERM-FOLLOW-UP; ESSENTIAL THROMBOCYTHEMIA; LIVER-TRANSPLANTATION; PROGNOSTIC-FACTORS; POLYCYTHEMIA-VERA; DIAGNOSIS; EPIDEMIOLOGY; LEUKOCYTOSIS; MULTICENTER;

D O I：

10.1038/bcj.2016.103

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We retrospectively studied 181 patients with polycythaemia vera (n = 67), essential thrombocythaemia (n= 67) or primary myelofibrosis (n = 47), who presented a first episode of splanchnic vein thrombosis (SVT). Budd-Chiari syndrome (BCS) and portal vein thrombosis were diagnosed in 31 (17.1%) and 109 (60.3%) patients, respectively; isolated thrombosis of the mesenteric or splenic veins was detected in 18 and 23 cases, respectively. After this index event, the patients were followed for 735 patient years (pt-years) and experienced 31 recurrences corresponding to an incidence rate of 4.2 per 100 pt-years. Factors associated with a significantly higher risk of recurrence were BCS (hazard ratio (HR): 3.03), history of previous thrombosis (HR: 3.62), splenomegaly (HR: 2.66) and leukocytosis (HR: 2.8). Vitamin K-antagonists (VKA) were prescribed in 85% of patients and the recurrence rate was 3.9 per 100 pt-years, whereas in the small fraction (15%) not receiving VKA more recurrences (7.2 per 100 pt-years) were reported. Intracranial and extracranial major bleeding was recorded mainly in patients on VKA and the corresponding rate was 2.0 per 100 pt-years. In conclusion, despite anticoagulation treatment, the recurrence rate after SVT in myeloproliferative neoplasms is high and suggests the exploration of new avenues of secondary prophylaxis with new antithrombotic drugs and JAK-2 inhibitors.

引用

页码：e493 / e493

页数：7

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