title: Cerebral vein thrombosis in patients with Philadelphia-negative myeloproliferative neoplasms. An European Leukemia Net study.
abstract: To investigate the characteristics and clinical course of cerebral vein thrombosis (CVT) in patients with myeloproliferative neoplasms (MPN) we compared 48 patients with MPN and CVT (group MPN-CVT) to 87 with MPN and other venous thrombosis (group MPN-VT) and 178 with MPN and no thrombosis (group MPN-NoT) matched by sex, age at diagnosis of MPN (±5 years) and type of MPN. The study population was identified among 5,500 patients with MPN, from January 1982 to June 2013. Thrombophilia abnormalities were significantly more prevalent in the MPN-CVT and MPN-VT than in MPN-NoT group (P = 0.015), as well as the JAK2 V617F mutation in patients with essential thrombocythemia (P = 0.059). Compared to MPN-VT, MPN-CVT patients had a higher rate of recurrent thrombosis (42% vs. 25%, P = 0.049) despite a shorter median follow-up period (6.1 vs. 10.3 years, P = 0.019), a higher long-term antithrombotic (94% vs. 84%, P = 0.099) and a similar cytoreductive treatment (79% vs. 70%, P = 0.311). The incidence of recurrent thrombosis was double in MPN-CVT than in MPN-VT group (8.8% and 4.2% patient-years, P = 0.022), and CVT and unprovoked event were the only predictive variables in a multivariate model including also sex, blood count, thrombophilia, cytoreductive, and antithrombotic treatment (HR 1.97, 95%CI 1.05-3.72 and 2.09, 1.09-4.00, respectively).
authors.affiliation: Angelo Bianchi Bonomi Hemophilia and Thrombosis, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Martinelli
authors.forename: Valerio
authors.initials: V
authors.lastname: De Stefano
authors.forename: Alessandra
authors.initials: A
authors.lastname: Carobbio
authors.forename: Maria L
authors.initials: ML
authors.lastname: Randi
authors.forename: Claudia
authors.initials: C
authors.lastname: Santarossa
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.forename: Maria C
authors.initials: MC
authors.lastname: Finazzi
authors.forename: Francisco
authors.initials: F
authors.lastname: Cervantes
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arellano-Rodrigo
authors.forename: Serena
authors.initials: S
authors.lastname: Rupoli
authors.forename: Lucia
authors.initials: L
authors.lastname: Canafoglia
authors.forename: Alessia
authors.initials: A
authors.lastname: Tieghi
authors.forename: Luca
authors.initials: L
authors.lastname: Facchini
authors.forename: Silvia
authors.initials: S
authors.lastname: Betti
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Vannucchi
authors.forename: Lisa
authors.initials: L
authors.lastname: Pieri
authors.forename: Rossella
authors.initials: R
authors.lastname: Cacciola
authors.forename: Emma
authors.initials: E
authors.lastname: Cacciola
authors.forename: Agostino
authors.initials: A
authors.lastname: Cortelezzi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Iurlo
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Pogliani
authors.forename: Elena M
authors.initials: EM
authors.lastname: Elli
authors.forename: Antonio
authors.initials: A
authors.lastname: Spadea
authors.forename: Tiziano
authors.initials: T
authors.lastname: Barbui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D005260:Female; D006401:Hematologic Agents / Q000627:therapeutic use; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000150:complications* / Q000453:epidemiology / Q000235:genetics; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology; D010677:Philadelphia Chromosome; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D013030:Spain / Q000453:epidemiology; D019851:Thrombophilia / Q000139:chemically induced / Q000453:epidemiology / Q000235:genetics; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal; D006401:Hematologic Agents