Volume 7, Issue 5, September 2019, Page: 112-117
The Frequency of Thromboembolism and Factors Associated with Thromboembolism in Patients Suffering from Polycythemia Vera
Mehmet Ali Uçar, Department of Hematology, Ankara Numune Training and Research Hospital, Ankara, Turkey
Simten Dağdaş, Department of Hematology, Ankara Numune Training and Research Hospital, Ankara, Turkey
Funda Ceran, Department of Hematology, Ankara Numune Training and Research Hospital, Ankara, Turkey
Mesude Falay, Department of Hematology, Ankara Numune Training and Research Hospital, Ankara, Turkey
Gülsüm Özet, Department of Hematology, Ankara Numune Training and Research Hospital, Ankara, Turkey
Received: Jul. 3, 2019;       Accepted: Jul. 27, 2019;       Published: Aug. 14, 2019
DOI: 10.11648/j.ajim.20190705.11      View  58      Downloads  37
Abstract
This study aimed to identify at what frequency of thromboembolic complications and the other risk factors that create a predisposition to thromboembolic complications occur in patients suffering from polycythemia vera (PV). In accordance with the 2001-2008 criteria put forth by World Health Organization, we reviewed the medical records of 207 patients who were diagnosed with PV between 2009 and 2017 at Ankara Numune Training and Research Hospital. We retrospectively looked at their demographical and clinical data, alongside their history of previous thrombotic events, what treatment they had received, and lab data at the time of diagnosis. We found that the mean hemoglobin and hematocrit levels, as well as their median white blood cell count and JAK2V617F positivity rate of those who had suffered thrombotic events were higher who had not. In addition, we also discovered that the mean age (60 vs. 55.3; p=0.012) and rate of tobacco use (62.9% vs. 23.7%; p<0.001) were both determined among the thrombotic groups versus the normal group. According to multivariate regression model of potential risk factors associated with thrombotic events, we had determined that smoking (OR=7.21; p<0.001), hypertension (OR=5.44; p=0.008), itching (OR=6.7; p=0.001), and JAK2V617F positivity (OR=2.61; p=0.043) were all independent risk factors that indicated the presence of an arterial event. We also arrived at the fact that smoking (OR=7.07; p=0.001) and itching (OR=12.9; p=0.001) were also independent risk factors predicting the presence of a venous event. Our findings conclusively reveal which risk factors are associated with thromboembolic events among PV patients. In light of that, we recommend that preventive measures be against these risk factors in order to decrease the frequency of thromboembolic complications that PV patients experience.
Keywords
Polycythemia Vera, Thrombosis, JAK2 Mutation
To cite this article
Mehmet Ali Uçar, Simten Dağdaş, Funda Ceran, Mesude Falay, Gülsüm Özet, The Frequency of Thromboembolism and Factors Associated with Thromboembolism in Patients Suffering from Polycythemia Vera, American Journal of Internal Medicine. Vol. 7, No. 5, 2019, pp. 112-117. doi: 10.11648/j.ajim.20190705.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Handgretinger, R. and M. Döring, Neoplastic Hematologic Disorders in Children and Adolescents, in Concise Guide to Hematology. 2019, Springer. p. 423-461.
[2]
O'Shea, J. J., M. Gadina, and R. M. Siegel, Cytokines and cytokine receptors, in Clinical Immunology. 2019, Elsevier. p. 127-155. e1.
[3]
Tefferi, A., Myeloproliferative Neoplasms: Essential Thrombocythemia, Primary Myelofibrosis, and Polycythemia Vera. Holland‐Frei Cancer Medicine, 2016: p. 1-14.
[4]
Kaifie, A., et al., Bleeding, thrombosis, and anticoagulation in myeloproliferative neoplasms (MPN): analysis from the German SAL-MPN-registry. Journal of hematology & oncology, 2016. 9 (1): p. 18.
[5]
Campbell, P. J. and A. R. Green, The myeloproliferative disorders. New England Journal of Medicine, 2006. 355 (23): p. 2452-2466.
[6]
Falanga, A., et al., Polymorphonuclear leukocyte activation and hemostasis in patients with essential thrombocythemia and polycythemia vera. Blood, 2000. 96 (13): p. 4261-4266.
[7]
Maugeri, N., et al., Inhibition of tissue factor expression by hydroxyurea in polymorphonuclear leukocytes from patients with myeloproliferative disorders: a new effect for an old drug? Journal of Thrombosis and Haemostasis, 2006. 4 (12): p. 2593-2598.
[8]
Ghaddar, A. I., Proposal for establishing a Nurse-Led International Normalized Ratio Outpatient Clinic at The American University of Beirut Medical Center. Theses, Dissertations, and Projects, 2017.
[9]
Marchioli, R., et al., Vascular and neoplastic risk in a large cohort of patients with polycythemia vera. Journal of Clinical Oncology, 2005. 23 (10): p. 2224-2232.
[10]
Tefferi, A., Annual Clinical Updates in Hematological Malignancies: A Continuing Medical Education Series: Polycythemia vera and essential thrombocythemia: 2011 update on diagnosis, risk‐stratification, and management. American journal of hematology, 2011. 86 (3): p. 292-301.
[11]
Barbui, T. and G. Finazzi. Risk factors and prevention of vascular complications in polycythemia vera. in Seminars in thrombosis and hemostasis. 1997. Copyright© 1997 by Thieme Medical Publishers, Inc.
[12]
Kreher, S., et al., Prophylaxis and management of venous thromboembolism in patients with myeloproliferative neoplasms: consensus statement of the Haemostasis Working Party of the German Society of Hematology and Oncology (DGHO), the Austrian Society of Hematology and Oncology (ÖGHO) and Society of Thrombosis and Haemostasis Research (GTH eV). Annals of Hematology, 2014. 93 (12): p. 1953-1963.
[13]
Passamonti, F., et al., Life expectancy and prognostic factors for survival in patients with polycythemia vera and essential thrombocythemia. The American journal of medicine, 2004. 117 (10): p. 755-761.
[14]
Warny, M., et al., Arterial and venous thrombosis by high platelet count and high hematocrit: 108, 521 individuals from the Copenhagen General Population Study. Journal of Thrombosis and Haemostasis, 2019.
[15]
Rao, G., Dietary Fat and Cholesterol Dilemma: Acute Vascular Events. Arc Clin Exp Cardiol, 2019. 1 (1): p. 101.
[16]
Barbui, T., et al., Development and validation of an International Prognostic Score of thrombosis in World Health Organization–essential thrombocythemia (IPSET-thrombosis). Blood, 2012. 120 (26): p. 5128-5133.
[17]
Barbui, T., et al., Practice-relevant revision of IPSET-thrombosis based on 1019 patients with WHO-defined essential thrombocythemia. Blood cancer journal, 2015. 5 (11): p. e369.
[18]
Barbui, T., et al., In contemporary patients with polycythemia vera, rates of thrombosis and risk factors delineate a new clinical epidemiology. Blood, 2014. 124 (19): p. 3021-3023.
[19]
Barbui, T., et al., The effect of arterial hypertension on thrombosis in low-risk polycythemia vera. American journal of hematology, 2017. 92 (1): p. E5.
[20]
Appelmann, I., et al., Diagnosis, prevention, and management of bleeding episodes in Philadelphia-negative myeloproliferative neoplasms: recommendations by the Hemostasis Working Party of the German Society of Hematology and Medical Oncology (DGHO) and the Society of Thrombosis and Hemostasis Research (GTH). Annals of hematology, 2016. 95 (5): p. 707-718.
[21]
Carobbio, A., et al., Risk factors for arterial and venous thrombosis in WHO-defined essential thrombocythemia: an international study of 891 patients. Blood, 2011. 117 (22): p. 5857-5859.
[22]
Lussana, F., et al., Association of V617F Jak2 mutation with the risk of thrombosis among patients with essential thrombocythaemia or idiopathic myelofibrosis: a systematic review. Thrombosis research, 2009. 124 (4): p. 409-417.
[23]
Hobbs, C. M., et al., JAK2V617F leads to intrinsic changes in platelet formation and reactivity in a knock-in mouse model of essential thrombocythemia. Blood, 2013. 122 (23): p. 3787-3797.
[24]
Tefferi, A., et al., The clinical phenotype of wild‐type, heterozygous, and homozygous JAK2V617F in polycythemia vera. Cancer: Interdisciplinary International Journal of the American Cancer Society, 2006. 106 (3): p. 631-635.
[25]
Wille, K., et al., High risk of recurrent venous thromboembolism in BCR-ABL-negative myeloproliferative neoplasms after termination of anticoagulation. Annals of hematology, 2019. 98 (1): p. 93-100.
Browse journals by subject