Department of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy.
University of Milano-Bicocca, Department of Medicine and Surgery, Monza, Italy.
Hamostaseologie. 2021 Feb;41(1):48-57. doi: 10.1055/a-1334-3259. Epub 2021 Feb 15.
Myeloproliferative neoplasms (MPNs) are clonal disorders of the hematopoietic stem cell. Classical BCR/ABL-negative MPNs include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). Thrombotic events are a major cause of morbidity and mortality in these patients. Pathogenesis of blood clotting activation involves various abnormalities of platelets, erythrocytes, and leukocytes, as well as dysfunctions of endothelial cells. Patients with MPN can be stratified in "high risk" or "low risk" of thrombosis according to established risk factors. ET and PV clinical management is highly dependent on the patient's thrombotic risk, and a risk-oriented management strategy to treat these diseases is strongly recommended. In this review, we give an overview of risk factors, pathogenesis, and thrombosis prevention and treatment in MPN.
骨髓增殖性肿瘤(MPN)是造血干细胞的克隆性疾病。经典的 BCR/ABL 阴性 MPN 包括真性红细胞增多症(PV)、原发性血小板增多症(ET)和原发性骨髓纤维化(PMF)。血栓事件是这些患者发病和死亡的主要原因。凝血激活的发病机制涉及血小板、红细胞和白细胞的各种异常以及内皮细胞的功能障碍。根据已确定的危险因素,MPN 患者可分为“高血栓风险”或“低血栓风险”。ET 和 PV 的临床管理高度依赖于患者的血栓风险,强烈推荐采用风险导向的管理策略来治疗这些疾病。在这篇综述中,我们概述了 MPN 中的危险因素、发病机制以及血栓预防和治疗。