Thrombosis in myeloproliferative neoplasms: a viewpoint on its impact on myelofibrosis, mortality, and solid tumors.
Autor: | Barbui T; FROM, Fondazione per la Ricerca Ospedale di Bergamo ETS, Bergamo, Italy. tbarbui@fondazionefrom.it., Ghirardi A; FROM, Fondazione per la Ricerca Ospedale di Bergamo ETS, Bergamo, Italy., Carobbio A; Dipartimento di Scienze Mediche e Chirurgiche, Materno-Infantili e dell'Adulto, Università di Modena-Reggio Emilia, Modena, Italy., De Stefano V; Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Rome, Italy.; Fondazione Policlinico Universitario A. Gemelli Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy., Rambaldi A; Divisione di Ematologia, ASST Papa Giovanni XXIII, Bergamo, Italy.; Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy., Tefferi A; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Vannucchi AM; CRIMM, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Florence, Italy. |
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Jazyk: | angličtina |
Zdroj: | Blood cancer journal [Blood Cancer J] 2024 Oct 25; Vol. 14 (1), pp. 188. Date of Electronic Publication: 2024 Oct 25. |
DOI: | 10.1038/s41408-024-01169-6 |
Abstrakt: | 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. (© 2024. The Author(s).) |
Databáze: | MEDLINE |
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