Kc Devendra, Falchi Lorenzo, Verstovsek Srdan
Department of Leukemia, MD Anderson Cancer Center, The University of Texas, 1515 Holcombe Blvd., Box 428, Houston, TX, 77030, USA.
Department of Hematology/Oncology, Columbia University Medical Center, New York, NY, USA.
Ann Hematol. 2017 Oct;96(10):1595-1604. doi: 10.1007/s00277-017-3099-2. Epub 2017 Aug 14.
Bleeding and thrombosis are long recognized complications of myelofibrosis (MF) and contribute significantly to its morbidity and mortality. However, so far, few studies have evaluated the frequency of these events, their characteristics, and their prognostic impact. Based on these studies, thrombotic events in MF are about as common as in essential thrombocytemia (ET) but less common than in polycythemia vera (PV), while bleeding events are relatively more common in MF than in ET or PV. The emergence of the concept of prefibrotic primary MF (PMF), which is associated with a higher frequency of thrombohemorrhagic complications than ET, and the growing evidence that prefibrotic PMF may also have a different thrombotic and bleeding risk profiles than fibrotic (overt) PMF have emphasized the need for a reappraisal of the risk of thrombosis and hemorrhage in patients with MF. In this review, we discuss the frequency of thrombosis and bleeding in patients with MF, including prefibrotic PMF and their established and potential risk factors.
出血和血栓形成是骨髓纤维化（MF）长期以来公认的并发症，对其发病率和死亡率有重大影响。然而，到目前为止，很少有研究评估这些事件的发生率、特征及其预后影响。基于这些研究，MF中的血栓形成事件与原发性血小板增多症（ET）中的情况大致相同，但比真性红细胞增多症（PV）中的情况少见，而出血事件在MF中比在ET或PV中相对更常见。纤维化前原发性MF（PMF）这一概念的出现，其与血栓出血并发症的发生率高于ET相关，并且越来越多的证据表明，纤维化前PMF的血栓形成和出血风险特征可能也与纤维化（显性）PMF不同，这凸显了重新评估MF患者血栓形成和出血风险的必要性。在本综述中，我们讨论了MF患者（包括纤维化前PMF）血栓形成和出血的发生率及其已确定的和潜在的危险因素。
