Title |
Antithrombotic therapy for venous thromboembolism in myeloproliferative neoplasms
|
---|---|
Published in |
Blood Cancer Journal, June 2018
|
DOI | 10.1038/s41408-018-0101-8 |
Pubmed ID | |
Authors |
Valerio De Stefano, Guido Finazzi, Tiziano Barbui |
Abstract |
In myeloproliferative neoplasms (MPNs) the incidence of venous thromboembolism (VTE) is 0.6-1.0 per 100 pt-years, and the rate of recurrence after VTE is 6.0-6.5 per 100 pt-yrs. Vitamin K-antagonists (VKA) reduces the risk of recurrence after VTE at usual sites (i.e., deep venous thrombosis (DVT) of the legs and pulmonary embolism (PE)) by 48-69%, with a rate of recurrent thrombosis per 100 pt-yrs of 3.4-4.7 on VKA and 8.9-9.6 off VKA; VKA discontinuation produces a 2.2-fold increased risk of novel thrombotic events with respect to continuation. However, the rate of both recurrent thrombosis and major bleeding on VKA is higher in MPN patients than in non-MPN patients, and the risk-benefit balance of long-term VKA treatment is challenging. In the absence of strong evidence, the tailored management of MPN-related VTE should operatively consider the risk categories for recurrence and bleed well established in the non-MPN setting. In summary, MPN patients with VTE are candidates for life-long VKA treatment, especially after unprovoked proximal DVT and PE. Aspirin can offer a moderate benefit in those patients who stop anticoagulation. The use of direct oral anticoagulants should be explored aiming to ameliorate the rate of bleeding. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 25 | 27% |
Brazil | 7 | 8% |
Spain | 5 | 5% |
Mexico | 5 | 5% |
Canada | 5 | 5% |
Saudi Arabia | 2 | 2% |
Turkey | 2 | 2% |
Morocco | 2 | 2% |
France | 2 | 2% |
Other | 13 | 14% |
Unknown | 24 | 26% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 57 | 62% |
Scientists | 17 | 18% |
Practitioners (doctors, other healthcare professionals) | 15 | 16% |
Science communicators (journalists, bloggers, editors) | 3 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 55 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 11 | 20% |
Other | 5 | 9% |
Student > Doctoral Student | 5 | 9% |
Student > Ph. D. Student | 5 | 9% |
Professor > Associate Professor | 3 | 5% |
Other | 8 | 15% |
Unknown | 18 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 31 | 56% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
Biochemistry, Genetics and Molecular Biology | 1 | 2% |
Unspecified | 1 | 2% |
Engineering | 1 | 2% |
Other | 1 | 2% |
Unknown | 18 | 33% |