Wille Kai, Deventer Eva, Sadjadian Parvis, Becker Tatjana, Kolatzki Vera, Hünerbein Karlo, Meixner Raphael, Jiménez-Muñoz Marina, Fuchs Christiane, Griesshammer Martin
University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, Johannes Wesling Medical Center Minden, University of Bochum, Bochum, Germany.
Core Facility Statistical Consulting, Helmholtz Zentrum München, Munich, Germany.
Hamostaseologie. 2024 Oct;44(5):386-392. doi: 10.1055/a-2159-8767. Epub 2023 Oct 9.
Arterial (ATE) and venous (VTE) thromboembolic complications are common causes of morbidity and mortality in -negative myeloproliferative neoplasms (MPNs). However, there are few studies that include all MPN subtypes and focus on both MPN-associated ATE and VTE. In our single-center retrospective study of 832 MPN patients, a total of 180 first thromboembolic events occurred during a median follow-up of 6.6 years (range: 0-37.6 years), of which 105 were VTE and 75 were ATE. The probability of a vascular event at the end of the follow-up period was 36.2%, and the incidence rate for all first ATE/VTE was 2.43% patient/year. The most frequent VTE localizations were deep vein thrombosis with or without pulmonary embolism (incidence rate: 0.59% patient/year), while strokes were the most frequent ATE with an incidence rate of 0.32% patient/year. When comparing the group of patients with ATE/VTE ( = 180) and the group without such an event ( = 652) using multivariate Cox regression analyses, patients with polycythemia vera (hazard ratio [HR]: 1.660; [95% confidence interval [CI] 1.206, 2.286]) had a significantly higher risk of a thromboembolic event than the other MPN subtypes. In contrast, patients with a mutation had a significantly lower risk of thromboembolism compared with -mutated MPN patients (HR: 0.346; [95% CI: 0.172, 0.699]). In summary, a high incidence of MPN-associated VTE and ATE was observed in our retrospective study. While PV patients or generally -mutated MPN patients had a significantly increased risk of such vascular events, this risk was reduced in -mutated MPN patients.
动脉(ATE)和静脉(VTE)血栓栓塞并发症是骨髓增殖性肿瘤(MPN)阴性患者发病和死亡的常见原因。然而,很少有研究涵盖所有MPN亚型,并且同时关注MPN相关的ATE和VTE。在我们对832例MPN患者的单中心回顾性研究中,在中位随访6.6年(范围:0 - 37.6年)期间共发生180例首次血栓栓塞事件,其中105例为VTE,75例为ATE。随访期末发生血管事件的概率为36.2%,所有首次ATE/VTE的发生率为2.43%/患者/年。VTE最常见的部位是伴有或不伴有肺栓塞的深静脉血栓形成(发生率:0.59%/患者/年),而中风是最常见的ATE,发生率为0.32%/患者/年。使用多变量Cox回归分析比较发生ATE/VTE的患者组(n = 180)和未发生此类事件的患者组(n = 652)时,真性红细胞增多症患者(风险比[HR]:1.660;[95%置信区间[CI] 1.206, 2.286])发生血栓栓塞事件的风险显著高于其他MPN亚型。相比之下,与JAK2突变的MPN患者相比,CALR突变的患者发生血栓栓塞的风险显著降低(HR:0.346;[95% CI:0.172, 0.699])。总之,在我们的回顾性研究中观察到MPN相关的VTE和ATE发生率较高。虽然真性红细胞增多症患者或一般JAK2突变的MPN患者发生此类血管事件的风险显著增加,但CALR突变的MPN患者的这种风险降低。