FROM, Fondazione per la Ricerca Ospedale di Bergamo ETS, Bergamo, Italy.
Dipartimento di Scienze Mediche e Chirurgiche, Materno-Infantili e dell'Adulto, Università di Modena-Reggio Emilia, Modena, Italy.
Blood Cancer J. 2024 Oct 25;14(1):188. doi: 10.1038/s41408-024-01169-6.
This viewpoint summarizes findings from analyses of large personal patient databases of myeloproliferative neoplasms (MPNs) to assess the impact of thrombosis on mortality, disease progression, and second cancers (SC). Despite advances, the current incidence of arterial and venous thrombosis remains a challenge. These events appear to signal a more aggressive disease course, as evidenced by their association with myelofibrosis progression and mortality using multistate models and time-dependent multivariable analysis. Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), are associated with the aggressiveness of polycythemia vera (PV) and essential thrombocythemia (ET), linking thrombosis to SC risk. This suggests a common inflammatory pathway likely influencing cardiovascular disease and cancer incidence. Notably, this is observed more frequently in younger patients, likely due to prolonged exposure to MPN and environmental inflammatory triggers. These data underscore the need for new studies to validate these associations, delineate the sequence of events, and identify therapeutic targets to mitigate thrombotic events and potentially improve overall patient outcomes in MPN.
这一观点总结了对骨髓增生性肿瘤（MPN）大型患者个人数据库分析的结果，以评估血栓形成对死亡率、疾病进展和第二癌症（SC）的影响。尽管取得了进展，但目前动脉和静脉血栓形成的发生率仍然是一个挑战。这些事件似乎表明疾病进展更为激进，这一点可通过多状态模型和时间依赖性多变量分析，证明其与骨髓纤维化进展和死亡率相关。炎症生物标志物，如中性粒细胞与淋巴细胞比值（NLR），与原发性骨髓纤维化（PV）和特发性血小板增多症（ET）的侵袭性相关，将血栓形成与 SC 风险联系起来。这表明可能存在一条共同的炎症途径，影响心血管疾病和癌症的发病率。值得注意的是，这种情况在年轻患者中更为常见，可能是由于长期暴露于 MPN 和环境炎症触发因素所致。这些数据强调需要进行新的研究来验证这些关联，阐明事件的顺序，并确定治疗靶点，以减轻血栓形成事件，并有可能改善 MPN 患者的整体预后。
