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

Valerio De Stefano, Elena Rossi, Silvia Betti, A. M. Vannucchi, M. Ruggeri, F. Cervantes, A. Alvarez-Larrán, A. Iurlo, M. L. Randi, L. Pieri, P. Guglielmelli, E. Elli, M. C. Finazzi, G. Finazzi, E. Zetterberg, N. Vianelli, G. Gaidano, I. Nichele, D. Cattaneo, M. PalovaM. H. Ellis, E. Cacciola, A. Tieghi, J. C. Hernandez-Boluda, E. Pungolino, G. Specchia, D. Rapezzi, A. Forcina, C. Musolino, A. Carobbio, M. Griesshammer, T. Barbui

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Abstract

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.
Original languageEnglish
Pages (from-to)e493-e493
JournalBlood Cancer Journal
Volume6
DOIs
Publication statusPublished - 2016

Keywords

  • Hematology
  • Oncology

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