Cerebral vein thrombosis in patients with Philadelphia-negative myeloproliferative neoplasms. An European Leukemia Net study

Am J Hematol. 2014 Nov;89(11):E200-5. doi: 10.1002/ajh.23809. Epub 2014 Jul 31.

Abstract

To investigate the characteristics and clinical course of cerebral vein thrombosis (CVT) in patients with myeloproliferative neoplasms (MPN) we compared 48 patients with MPN and CVT (group MPN-CVT) to 87 with MPN and other venous thrombosis (group MPN-VT) and 178 with MPN and no thrombosis (group MPN-NoT) matched by sex, age at diagnosis of MPN (±5 years) and type of MPN. The study population was identified among 5,500 patients with MPN, from January 1982 to June 2013. Thrombophilia abnormalities were significantly more prevalent in the MPN-CVT and MPN-VT than in MPN-NoT group (P = 0.015), as well as the JAK2 V617F mutation in patients with essential thrombocythemia (P = 0.059). Compared to MPN-VT, MPN-CVT patients had a higher rate of recurrent thrombosis (42% vs. 25%, P = 0.049) despite a shorter median follow-up period (6.1 vs. 10.3 years, P = 0.019), a higher long-term antithrombotic (94% vs. 84%, P = 0.099) and a similar cytoreductive treatment (79% vs. 70%, P = 0.311). The incidence of recurrent thrombosis was double in MPN-CVT than in MPN-VT group (8.8% and 4.2% patient-years, P = 0.022), and CVT and unprovoked event were the only predictive variables in a multivariate model including also sex, blood count, thrombophilia, cytoreductive, and antithrombotic treatment (HR 1.97, 95%CI 1.05-3.72 and 2.09, 1.09-4.00, respectively).

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Contraceptives, Oral, Hormonal / adverse effects
  • Female
  • Hematologic Agents / therapeutic use
  • Hormone Replacement Therapy / adverse effects
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Myeloproliferative Disorders / complications*
  • Myeloproliferative Disorders / epidemiology
  • Myeloproliferative Disorders / genetics
  • Neoplasms, Multiple Primary / epidemiology
  • Philadelphia Chromosome
  • Postoperative Complications / epidemiology
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology
  • Pregnancy Complications, Neoplastic / epidemiology
  • Pulmonary Embolism / epidemiology
  • Pulmonary Embolism / etiology
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Sinus Thrombosis, Intracranial / diagnosis
  • Sinus Thrombosis, Intracranial / drug therapy
  • Sinus Thrombosis, Intracranial / epidemiology
  • Sinus Thrombosis, Intracranial / etiology*
  • Spain / epidemiology
  • Thrombophilia / chemically induced
  • Thrombophilia / epidemiology
  • Thrombophilia / genetics
  • Venous Thrombosis / epidemiology
  • Venous Thrombosis / etiology
  • Young Adult

Substances

  • Contraceptives, Oral, Hormonal
  • Hematologic Agents