A recent study identified factors associated with splanchnic vein thrombosis (SVT) in patients with myeloproliferative neoplasms (MPNs), with results reported in the American Journal of Hematology.

Vascular complications are a common cause of morbidity and mortality in patients with MPNs. Research has shown that SVT may occur in patients with MPNs at a rate of up to 13%.

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Researchers compared data from 518 patients with MPNs who had experienced SVT and a control population of 1628 patients with MPNs without SVT in this retrospective analysis of patient characteristics and outcomes.

Among patients who experienced SVT, 37.1% had polycythemia vera (PV), 34.4% had essential thrombocythemia (ET), and 13.1% had overt primary myelofibrosis (PMF). Hypercoagulable disorders were also present in 38.6% of patients who had SVT. Female patients and younger patients were more likely to experience SVT associated with MPNs.

A total of 90.2% of patients with SVT had a JAK2 V617F mutation, and this was significantly more prevalent among patients with ET (P <.0001) or PMF (P =.012) compared with control patients.

Initial SVT incidents occurred in the absence of antithrombotic prophylaxis for 85% of cases, but most patients (91.6% of evaluated cases) received prophylaxis following the initial SVT. SVT recurred at a rate of 1.6 events per 100 patient-years. Therapy with vitamin K antagonists was associated with a reduced rate of SVT recurrence (odds ratio, 0.48; 95% CI, 0.24-0.95; P =.034).

The researchers noted an increase in major bleeding among patients with SVT, primarily associated with esophageal varices (odds ratio, 17.4; 95% CI, 8.1-37.4; P <.0001)

The researchers concluded that certain patient features appear to be associated with SVT in the context of MPN and that vitamin K antagonists show promise in treatment of SVT associated with MPNs.

Reference

  1. Sant’Antonio E, Guglielmelli P, Pieri L, et al. Splanchnic vein thromboses associated with myeloproliferative neoplasms: An international, retrospective study on 518 cases [published online November 12, 2019]. Am J Hematol. doi:10.1002/ajh.25677