Myeloproliferative neoplasms: diagnosis, management and treatment

Tonkin, Joanne; Francis, Yvonne; Pattinson, A; Peters, Theresa; Taylor, Michelle; Thompson, Ruth; Wallis, Louise

doi:10.7748/ns.26.51.44.s55

Cited by 4 publications

(4 citation statements)

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“…Apart from that, it is reported that chemokines and cytokines produced by inflammatory reaction cause genetic instability, leading to the occurrence and development of tumors, and play an important role in the pathogenesis of Ph-MPNs. 44 Therefore, it is reasonable to confirm that infection plays an important role in the development of thrombotic events in patients with Ph-MPNs. In this study, patients with various age, sex, and blood cell showed no significant difference in the occurrence of thrombotic events, which showed that PAI-1 gene 4G/5G polymorphism and infection were related to thrombotic events.…”

Section: Discussionmentioning

confidence: 96%

Correlation Between PAI-1 Gene 4G/5G Polymorphism and the Risk of Thrombosis in Ph Chromosome-Negative Myeloproliferative Neoplasms

Zhang

Cai

Pan

2020

Clin Appl Thromb Hemost

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Thrombosis has been recognized as one of the most significant risk factors of high mortality and disability in patients with Philadelphia (Ph) chromosome negative myeloproliferative neoplasms (MPNs). However, the risk factors of thrombotic events in these patients have not been completely understood. In this study, the clinical data of 58 patients with Ph-MPNs were obtained and analyzed, including 34 cases of essential thrombocytopenia (ET), 23 thrombotic events happened in 21 (36%) patients, among which 60% (14 of 23) with cerebral infarction, 17% (4 of 23) with coronary heart disease and 23% (5 of 23) with venous thrombosis. There were no significant differences in age, sex, and blood cell count between polycythemia vera (PV) and ET patients who have experienced thrombotic events and those who have not. In ET patients, the incidence of thrombotic events in plasminogen activator inhibitor-1 (PAI-1) genotype 4G4G was significantly higher than that in genotype 4G5G and genotype 5G5G ( P < .05). The incidence of thrombotic events in PV and ET patients with infection was higher than those without infection ( P < .05). Using logistic regression analysis, we found that PAI-1 genotype 4G4G and infection were associated with thrombotic events (odds ratio 6.744, 95% CI: 1.195-38.056 and 15.641 95% CI: 3.327-73.522). The 4G/4G polymorphism of PAI-1 gene and infection are independent risk factors of thrombotic events in patients with Ph-MPNs. PAI-1 gene 4G4G and infection in ET and PV patients with Janus kinase 2 (JAK2) V617F mutation were shown to be high risk of thrombotic events. Therefore, clinical doctors should put more attention on PAI-1 genotype 4G4G and infection in JAK2 V617F mutated patients with Ph-MPNs to prevent the thrombosis.

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Section: Discussionmentioning

confidence: 96%

Correlation Between PAI-1 Gene 4G/5G Polymorphism and the Risk of Thrombosis in Ph Chromosome-Negative Myeloproliferative Neoplasms

Zhang

Cai

Pan

2020

Clin Appl Thromb Hemost

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“…Arterial thrombosis, the direct cause of cardiovascular events, is the main risk factor affecting the survival of MPN patients ( 25 ). Thromboembolism-related mortality accounts for 35%–70% of the total mortality of MPN ( 26 ), with ACS being the common one ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Prediction of acute coronary syndrome in patients with myeloproliferative neoplasms

Huang,

Zhang,

Shen

et al. 2024

Front. Cardiovasc. Med.

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BackgroundPatients with myeloproliferative neoplasms (MPN) are exposed to a higher risk of cardiovascular disease, especially cardiovascular calcification. The present research aimed to analyze the clinical features and coronary artery calcium score (CACS) in MPN patients, and construct an effective model to predict acute coronary syndrome (ACS) in MPN patients.Materials and methodsA total of 175 MPN patients and 175 controls were recruited from the First Affiliated Hospital of Ningbo University. Based on cardiovascular events, the MPN patients were divided into the ACS group and the non-ACS group. Multivariate Cox analysis was completed to explore ACS-related factors. Furthermore, ROC curves were plotted to assess the predictive effect of CACS combined with white blood cells (WBC) and platelet for ACS in MPN patients.ResultsThe MPN group exhibited a higher CACS than the control group (133 vs. 55, P < 0.001). A total of 16 patients developed ACS in 175 MPN patients. Compared with non-ACS groups, significant differences in age, diabetes, smoking history, WBC, percentage of neutrophil, percentage of lymphocyte, neutrophil count, hemoglobin, hematocrit, platelet, lactate dehydrogenase, β2-microglobulin, and JAK2V617F mutation were observed in the ACS groups. In addition, the CACS in the ACS group was also significantly higher than that in the non-ACS group (374.5 vs. 121, P < 0.001). The multivariable Cox regression analysis identified WBC, platelet, and CACS as independent risk factors for ACS in MPN patients. Finally, ROC curves indicated that WBC, platelet, and CACS have a high predictive value for ACS in MPN patients (AUC = 0.890).ConclusionCACS combined with WBC and platelet might be a promising model for predicting ACS occurrence in MPN patients.

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“…In contrast, as far as the cases of venous thrombosis are concerned, only the male sex was found to be significantly linked to these events [30]. The relationship between thrombosis and leukocytosis, thrombosis and JAK2V617F6, or pregnancy-associated complications and JAK2V617F has been examined by different groups of investigators with conflicting and inconclusive results [31][32][33].…”

Section: • Low Risk (Absence Of Both Risk Factors)mentioning

confidence: 99%

Cerebral Sinus Vein Thrombosis and Gender: A Not Entirely Casual Relationship

2023

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Cerebral sinus venous thrombosis (CSVT) is a relatively rare acute disorder of cerebral circulation, but it can potentially be associated with serious sequelae and a poor prognosis. The neurological manifestations associated with it are often not adequately taken into consideration given the extreme variability and nuances of its clinical presentation and given the need for radiological methods suitable for this type of diagnosis. CSVT is usually more common in women, but so far there are little data available in the literature on sex-specific characteristics regarding this pathology. CSVT is the result of multiple conditions and is therefore to be considered a multifactorial disease where at least one risk factor is present in over 80% of cases. From the literature, we learn that congenital or acquired prothrombotic states are to be considered extremely associated with the occurrence of an acute episode of CSVT and its recurrences. It is, therefore, necessary to fully know the origins and natural history of CSVT, in order to implement the diagnostic and therapeutic pathways of these neurological manifestations. In this report, we summarize the main causes of CSVT considering the possible influence of gender, bearing in mind that most of the causes listed above are pathological conditions closely linked to the female sex.

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Myeloproliferative neoplasms: diagnosis, management and treatment

Abstract: This article provides an overview of myeloproliferative neoplasms for nurses who do not specialise in haematology. Diagnosis, management and treatment of patients with these conditions is discussed, as well as long-term nursing implications.

Cited by 4 publications

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Correlation Between PAI-1 Gene 4G/5G Polymorphism and the Risk of Thrombosis in Ph Chromosome-Negative Myeloproliferative Neoplasms

Correlation Between PAI-1 Gene 4G/5G Polymorphism and the Risk of Thrombosis in Ph Chromosome-Negative Myeloproliferative Neoplasms

Prediction of acute coronary syndrome in patients with myeloproliferative neoplasms

Cerebral Sinus Vein Thrombosis and Gender: A Not Entirely Casual Relationship

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