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How to manage thrombosis in myeloproliferative neoplasms

2011; Lippincott Williams & Wilkins; Volume: 23; Issue: 6 Linguagem: Inglês

10.1097/cco.0b013e32834bb867

1531-703X

Tiziano Barbui,

Acute Myeloid Leukemia Research

Purpose of review In this article, an updated overview of risk factors and management of vascular complications in myeloproliferative neoplasms (MPN) is presented. Recent findings The rate of thrombosis in patients with polycythemia vera, essential thrombocythemia, and primary myelofibrosis is elevated and a risk-oriented therapeutic approach is recommended to avoid inappropriate exposure to cytotoxic drugs on one side or suboptimal treatment on the other. Established thrombosis risk factors are age and previous vascular events but novel disease-related determinants such as leukocytosis and JAK2V617F mutational status and/or mutational burden are now under active investigation. The theory that elevated platelet count increases thrombosis risk in these diseases is now challenged. Summary Recent recommendations by the European Leukemia Net suggest that MPN patients should be stratified and treated according to conventional risk factors (age and previous events) and that baseline leukocytosis and JAK2V617F mutation should be considered once more information is available and when they have been eventually validated in prospective studies.