Prediction of thrombosis in post-polycythemia vera and post-essential thrombocythemia myelofibrosis: a study on 1258 patients.

Humans Hydroxyurea / therapeutic use Janus Kinase Inhibitors Polycythemia Vera / complications Primary Myelofibrosis / etiology Thrombocythemia, Essential / complications Thrombosis / etiology

Journal

Leukemia
ISSN: 1476-5551
Titre abrégé: Leukemia
Pays: England
ID NLM: 8704895

Informations de publication

Date de publication:
10 2022
Historique:
received: 07 05 2022
accepted: 27 07 2022
revised: 25 07 2022
pubmed: 31 8 2022
medline: 4 10 2022
entrez: 30 8 2022
Statut: ppublish

Résumé

Patients with Philadelphia-negative myeloproliferative neoplasms are at high risk of thrombotic events (TEs). Predisposing factors have been identified in essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (primary MF, PMF), while yet not recognized in post PV/ET-MF (known as secondary MF, SMF). Within the 1258 SMF of the MYSEC (MYelofibrosis SECondary to PV and ET) dataset, 135 (10.7%) developed a TE at a median follow-up of 3.5 years (range, 1-21.4), with an incidence of 2.3% patients per year. Venous events accounted for two-thirds of the total. Cox multivariable analysis, supported by Fine-Gray models with death as competitive risk, showed that being on cytoreductive therapy at time of SMF evolution is associated with an absolute risk reduction of thrombosis equal to 3.3% within 3 years. Considering individually cytoreductive therapies, univariate regression model found that both conventional cytoreduction, mainly hydroxyurea, (HR 0.41, 95% CI: 0.26-0.65, p = 0.0001) and JAK inhibitors, mostly ruxolitinib, (HR 0.50, 95% CI: 0.24-1.02, p = 0.05) were associated with fewer thrombosis. Our study informs treating physicians of a non-low incidence of TEs in post PV/ET-MF and of the potential protective role of cytoreductive therapy in terms of thrombotic events.

Identifiants

DOI: 10.1038/s41375-022-01673-3 PMID: 36042316
pubmed: 36042316
doi: 10.1038/s41375-022-01673-3
pii: 10.1038/s41375-022-01673-3
doi:

Substances chimiques

Janus Kinase Inhibitors 0
Hydroxyurea X6Q56QN5QC

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2453-2460

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer Nature Limited.

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Auteurs

Barbara Mora (B)

Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Paola Guglielmelli (P)

Center of Research and Innovation of Myeloproliferative Neoplasms, University of Florence, Florence, Italy.
ORCID: 0000-0003-1809-284X

Andrew Kuykendall (A)

Malignant Hematology Department, Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.

Elisa Rumi (E)

Hematology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
ORCID: 0000-0002-7572-9504

Margherita Maffioli (M)

Hematology, Ospedale di Circolo, ASST Sette Laghi, Varese, Italy.

Francesca Palandri (F)

Institute of Hematology, Azienda Ospedaliero-Universitaria S.Orsola-Malpighi di Bologna, Bologna, Italy.
ORCID: 0000-0001-8367-5668

Valerio De Stefano (V)

Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
ORCID: 0000-0002-5178-5827

Marianna Caramella (M)

Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Silvia Salmoiraghi (S)

FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo, Italy.

Jean-Jacques Kiladjian (JJ)

Centre d'Investigations Cliniques, Hôpital Saint-Louis et Université Paris Diderot, Paris, France.

Jason Gotlib (J)

Division of Hematology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA.

Alessandra Iurlo (A)

UOC Ematologia, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
ORCID: 0000-0002-4401-0812

Francisco Cervantes (F)

Hematology Department, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.
ORCID: 0000-0003-2664-8131

Marco Ruggeri (M)

Hematology Department, San Bortolo Hospital, Vicenza, Italy.

Richard T Silver (RT)

Richard T. Silver Myeloproliferative Neoplasms Center, Weill Cornell Medical Center, New York, NY, USA.
ORCID: 0000-0002-8524-0964

Francesco Albano (F)

Hematology - Dept. of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
ORCID: 0000-0001-7926-6052

Giulia Benevolo (G)

Hematology, AOU Città della Salute e della Scienza di Torino, Turin, Italy.

David M Ross (DM)

Haematology Directorate, SA Pathology, Royal Adelaide Hospital and Flinders Medical Centre, Adelaide, South Australia.
ORCID: 0000-0001-7171-2935

Matteo G Della Porta (MG)

IRCCS Humanitas Clinical and Research Center, Rozzano, Italy.

Timothy Devos (T)

Department of Hematology, University Hospitals Leuven and Department of Microbiology and Immunology, Laboratory of Molecular Immunology (Rega Institute), Ku Leuven, Leuven, Belgium.
ORCID: 0000-0002-6881-417X

Giada Rotunno (G)

Center of Research and Innovation of Myeloproliferative Neoplasms, University of Florence, Florence, Italy.

Rami S Komrokji (RS)

Malignant Hematology Department, Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
ORCID: 0000-0002-1876-5269

Ilaria C Casetti (IC)

Hematology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.

Michele Merli (M)

Hematology, Ospedale di Circolo, ASST Sette Laghi, Varese, Italy.
ORCID: 0000-0002-0905-5927

Marco Brociner (M)

Hematology, Ospedale di Circolo, ASST Sette Laghi, Varese, Italy.

Domenica Caramazza (D)

Hematology, Ospedale di Circolo, ASST Sette Laghi, Varese, Italy.

Giuseppe Auteri (G)

Institute of Hematology, Azienda Ospedaliero-Universitaria S.Orsola-Malpighi di Bologna, Bologna, Italy.

Tiziano Barbui (T)

FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo, Italy.
ORCID: 0000-0003-2747-6327

Daniele Cattaneo (D)

UOC Ematologia, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.

Lorenza Bertù (L)

Department of Medicine and Surgery, University of Insubria, Varese, Italy.

Luca Arcaini (L)

Hematology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.

Alessandro M Vannucchi (AM)

Center of Research and Innovation of Myeloproliferative Neoplasms, University of Florence, Florence, Italy.

Francesco Passamonti (F)

Department of Medicine and Surgery, University of Insubria, Varese, Italy. francesco.passamonti@uninsubria.it.
ORCID: 0000-0001-8068-5289

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prediction of thrombosis in post-polycythemia...
questionsmedicales.fr › Composés chimiques organiques › Amides › Urée › Hydroxy-urée › Prediction of thrombosis in post-polycythemia...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Mécanismes moléculaires de l'action pharmacologique › Antienzymes › Inhibiteurs de protéines kinases › Inhibiteurs des Janus kinases › Prediction of thrombosis in post-polycythemia...
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Tumeurs hématologiques › Tumeurs de la moelle osseuse › Polyglobulie primitive essentielle › Prediction of thrombosis in post-polycythemia...
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Maladies de la moelle osseuse › Syndromes myéloprolifératifs › Myélofibrose primitive › Prediction of thrombosis in post-polycythemia...
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Troubles hémorragiques › Thrombocytémie essentielle › Prediction of thrombosis in post-polycythemia...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thrombose › Prediction of thrombosis in post-polycythemia...