Wille, K.* ; Sadjadian, P.* ; Becker, T.* ; Kolatzki, V.* ; Horstmann, A.* ; Fuchs, C. ; Griesshammer, M.*
High risk of recurrent venous thromboembolism in BCR-ABL-negative myeloproliferative neoplasms after termination of anticoagulation.
Ann. Hematol. 98, 93-100 (2019)
Venous thromboembolism (VTE) is a major burden in patients with BCR-ABL-negative myeloproliferative neoplasms (MPN). In addition to cytoreductive treatment anticoagulation is mandatory, but optimal duration of anticoagulation is a matter of debate. In our single center study, we retrospectively included 526 MPN patients. In total, 78 of 526 MPN patients (14.8%) had 99 MPN-associated VTE. Median age at first VTE was 52.5years (range 23-81). During a study period of 3497years, a VTE event rate of 1.7% per patient/year was detected. 38.4% (38/99) of all VTEs appeared before or at MPN diagnosis and 55.6% (55/99) occurred at uncommon sites like splanchnic or cerebral veins. MPN patients with VTEs were significantly more female (p=0.028), JAK2 positive (p=0.018), or had a polycythemia vera (p=0.009). MPN patients without VTEs were more often CALR positive (p=0.023). Total study period after first VTE was 336years with 20 VTE recurrences accounting for a recurrence rate of 6% per patient/year. In 36 of 71 MPN patients with anticoagulation therapy after first VTE event (50.7%), prophylactic anticoagulation was terminated after a median time of 6months (range 1-61); 13 of those 36 patients (36.1%) had a VTE recurrence after a median of 13months (range 4-168). In contrast, only three of 35 (8.6%) patients with ongoing anticoagulation had a VTE recurrence (p=0.0127). Thus, termination of prophylactic anticoagulation was associated with a significantly higher risk of VTE recurrence. Our data suggest that in MPN patients with VTE, a prolonged duration of anticoagulation may be beneficial.
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Article: Journal article
Document type
Scientific Article
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Keywords
Myeloproliferative Neoplasms ; Recurrent Venous Thromboembolism ; Anticoagulation Therapy; Essential Thrombocythemia; Polycythemia-vera; Oral Rivaroxaban; Thrombosis; Myelofibrosis; Epidemiology; Prophylaxis; Hydroxyurea; Anagrelide; Intensity
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Publication Year
2019
Prepublished in Year
2018
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2018
ISSN (print) / ISBN
0939-5555
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1432-0584
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Volume: 98,
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Pages: 93-100
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Springer
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233 Spring St, New York, Ny 10013 Usa
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Peer reviewed
POF-Topic(s)
30205 - Bioengineering and Digital Health
Research field(s)
Enabling and Novel Technologies
PSP Element(s)
G-503800-001
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Erfassungsdatum
2018-09-05