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Myeloproliferative neoplasms significantly increase thrombotic risk

The rate of arterial and venous thrombosis was significant in patients with myeloproliferative neoplasms, according to research published in Annals of Internal Medicine.

“Patients with myeloproliferative neoplasms have been reported to be at increased risk for thrombotic events, but no population-based study has estimated this excess risk compared with matched control participants,” Malin Hultcrantz, MD, PhD, from Karolinska University Hospital and Karolinska Institutet, Stockholm, and colleagues wrote.

To address this gap in knowledge, Hultcrantz and colleagues evaluated data from all patients diagnosed with myeloproliferative neoplasms who reported to the Swedish Cancer Register between 1987 and 2009. The researchers identified 9,429 patients with myeloproliferative neoplasms, matched them to 35,820 control participants and compared their rates of arterial and venous thrombosis. Follow-up was conducted up to 2010.

Data showed that patients with myeloproliferative neoplasms had HRs for arterial thrombosis of 3 (95% CI, 2.7-3.4) at 3 months, 2 (95% CI, 1.8-2.2) at 1 year and 1.5 (95% CI, 1.4-1.6) at 5 years, compared with matched controls. These patients also had HRs for venous thrombosis of 9.7 (95% CI, 7.8-12) at 3 months, 4.7 (95% CI, 4-5.4) at 1 year and 3.2 (95% CI, 2.9-3.6) at 5 years, compared with matched controls.

The rates of arterial and venous thrombosis were higher across all age groups and were similar among subtypes of myeloproliferative neoplasms. Incidences of arterial and venous thrombosis spiked shortly after diagnosis and gradually lessened, but remained significant, during follow-up in patients with myeloproliferative neoplasms.

“Of note, the HR for thrombotic events decreased with time after diagnosis, likely due to effective treatment of the underlying [myeloproliferative neoplasms], and the HR for venous thrombosis was lower in patients diagnosed during more recent calendar periods,” Hultcrantz and colleagues concluded. “These results are encouraging, and we believe that further refinement of risk scoring systems (such as by including time since [myeloproliferative neoplasms] diagnosis and biomarkers); rethinking of recommendations for younger patients with [myeloproliferative neoplasms]; and emerging, more effective treatments will further improve outcomes for patients with [myeloproliferative neoplasms].”

In a related editorial, Alison R. Moliterno, MD, and Elizabeth V. Ratchford, MD, both from the Johns Hopkins University School of Medicine, wrote that the findings by Hultcrantz and colleagues elucidate the extent of arterial and venous thrombosis risk in patients with myeloproliferative neoplasms.

“Care of patients with [myeloproliferative neoplasms] should include aggressive treatment of traditional risk factors to reduce risk for arterial and venous thrombosis, regardless of age; adoption of dietary and lifestyle habits that reduce inflammation; and consideration of combined anticoagulant, antiplatelet, and anti-inflammatory treatment strategies,” they wrote. – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.