Zhang Y H, Teng G S, Ma J Y, Hu X, Du C X, Wang Y, Hu N B, Li Y Q, Shao Z H, Bai J
Department of Hematology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Zhonghua Yi Xue Za Zhi. 2023 Dec 5;103(45):3652-3657. doi: 10.3760/cma.j.cn112137-20231007-00647.
To analyze the risk factors of thrombosis in patients with JAK2 mutation positive myeloproliferative neoplasms (MPN). A total of 223 MPN patients with JAK2 mutation in the Second Hospital of Tianjin Medical University from September 2017 to May 2023 were retrospectively enrolled, including 111 males and 112 females, aged [(,)] 57(21,66) years. According to the presence or absence of thromboembolism during follow-up, the patients were divided into thrombosis group (=102) and non-thrombosis group (=121). The clinical characteristics, laboratory characteristics, cytogenetics and other disease progression and survival of the two groups of patients were analyzed. As of March 31, 2023, the follow-up period [ (, )] was 6 (3, 10) years. The influencing factors of thrombosis in JAK2 positive MPN patients were analyzed by using the Cox risk model. Among 223 JAK2 positive MPN patients, 144 were polycythemia vera (PV), 51 were essential thrombocythemia (ET) and 28 were primary myelofibrosis (PMF). The mutation rates of ASXL1 and BCORL1 genes in the thrombosis group were 19.6% (20/102) and 6.9% (7/102), respectively, which were higher than those in the non-thrombosis group [9.1% (11/121) and 0.8% (1/121)] (both <0.05). The proportion of monocytes, C-reactive protein (CRP), interleukin-1β (IL)-1β, IL-8 and tumor necrosis factor-β (TNF-β) increased in the thrombosis group were higher than those in the non-thrombosis group (all <0.05). Multivariate analysis showed that age≥60 years (=2.132, 95%: 1.376-3.303, =0.001), history of thrombosis (=3.636, 95%: 2.121-6.202, <0.001), ASXL1 mutation positive (=2.245, 95%: 1.093-3.231, =0.022) and elevated TNF-β (=2.009, 95%: 1.113-3.624, =0.021) were risk factors for thrombosis in JAK2 positive MPN patients. In addition to age, history of thrombosis and positive ASXL1 mutation, elevated TNF-β is also an influencing factor of thrombosis in JAK2 positive MPN patients. Intervention of inflammation may have a certain effect on the prevention and treatment of thrombosis.
分析JAK2突变阳性骨髓增殖性肿瘤（MPN）患者血栓形成的危险因素。回顾性纳入2017年9月至2023年5月在天津医科大学第二医院就诊的223例JAK2突变的MPN患者，其中男性111例，女性112例，年龄[（，）]57（21，66）岁。根据随访期间是否发生血栓栓塞，将患者分为血栓形成组（=102）和非血栓形成组（=121）。分析两组患者的临床特征、实验室特征、细胞遗传学及其他疾病进展和生存情况。截至2023年3月31日，随访时间[（，）]为6（3，10）年。采用Cox风险模型分析JAK2阳性MPN患者血栓形成的影响因素。在223例JAK2阳性MPN患者中，真性红细胞增多症（PV）144例，原发性血小板增多症（ET）51例，原发性骨髓纤维化（PMF）28例。血栓形成组ASXL1和BCORL1基因的突变率分别为19.6%（20/102）和6.9%（7/102），高于非血栓形成组[9.1%（11/121）和0.8%（1/121）]（均<0.05）。血栓形成组单核细胞比例、C反应蛋白（CRP）、白细胞介素-1β（IL）-1β、IL-8和肿瘤坏死因子-β（TNF-β）升高的比例高于非血栓形成组（均<0.05）。多因素分析显示，年龄≥60岁（=2.132，95%：1.376-3.303，=0.001）、血栓形成病史（=3.636，95%：2.121-6.202，<0.001）、ASXL1突变阳性（=2.245，95%：1.093-3.231，=0.022）和TNF-β升高（=2.009，95%：1.113-3.624，=0.021）是JAK2阳性MPN患者血栓形成的危险因素。除年龄、血栓形成病史和ASXL1突变阳性外，TNF-β升高也是JAK2阳性MPN患者血栓形成的影响因素。炎症干预可能对血栓的防治有一定作用。
