title: 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 e.V.).
abstract: Patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) like polycythemia vera and essential thrombocythemia are at increased risk of arterial and venous thrombosis. Strategies of prevention may consist of platelet aggregation inhibitors and/or cytoreductive agents depending on the underlying disease and the individual risk. Clinical evidence for management of acute venous thromboembolic events in MPN patients is limited. Modality and duration of therapeutic anticoagulation after venous thrombosis has to be evaluated critically with special regard to the increased risk for spontaneous bleeding events associated with the underlying diseases. Both for therapy of the acute event and for secondary prophylaxis, low-molecular-weight heparins should preferentially be used. A prolongation of the therapeutic anticoagulation beyond the usual 3 to 6 months can only be recommended in high-risk settings and after careful evaluation of potential risks and benefits for the individual patient. New direct oral anticoagulants (NOAC) should not preferentially be used due to lack of clinical experience in patients with MPN and potential drug interactions (e.g. with JAK inhibitors). Consequent treatment of the underlying myeloproliferative disease and periodical evaluation of the response to therapy is crucial for optimal secondary prophylaxis of thromboembolic events in those patients.
authors.affiliation: Department of Hematology and Oncology, Charite Berlin, Berlin, Hindenburgdamm 30, 12200, Berlin, Germany, stephan.kreher@charite.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Kreher
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ochsenreither
authors.forename: Ralf U
authors.initials: RU
authors.lastname: Trappe
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
authors.forename: Frauke
authors.initials: F
authors.lastname: Bergmann
authors.forename: Petro E
authors.initials: PE
authors.lastname: Petrides
authors.forename: Steffen
authors.initials: S
authors.lastname: Koschmieder
authors.forename: Axel
authors.initials: A
authors.lastname: Matzdorff
authors.forename: Andreas
authors.initials: A
authors.lastname: Tiede
authors.forename: Martin
authors.initials: M
authors.lastname: Griesshammer
authors.forename: Hanno
authors.initials: H
authors.lastname: Riess
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004198:Disease Susceptibility; D004347:Drug Interactions; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D015994:Incidence; D054438:Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / Q000097:blood / Q000150:complications; D008297:Male; D009196:Myeloproliferative Disorders / Q000097:blood / Q000150:complications* / Q000628:therapy; D018962:Phlebotomy; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy / Q000517:prevention & control; D011300:Preoperative Care; D047428:Protein Kinase Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D055502:Secondary Prevention; D019851:Thrombophilia / Q000188:drug therapy* / Q000209:etiology; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*; D014842:von Willebrand Diseases / Q000209:etiology / Q000503:physiopathology
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; C021139:anagrelide; D006918:Hydroxyurea