title: Mechanisms of thrombogenesis in polycythemia vera.
abstract: Thrombotic and cardiovascular events are among the leading causes of death for patients with polycythemia vera (PV), and thrombosis history is a key criterion for patient risk stratification and treatment strategy. Little is known, however, about mechanisms of thrombogenesis in patients with PV. This report provides an overview of thrombogenesis pathophysiology in patients with PV and elucidates the roles of conventional and nonconventional thrombotic risk factors. In addition to several conventional risk factors for thrombosis, clinical data have implicated increased hematocrit and red blood cell adhesiveness, activated platelets, leukocytosis, and elevated JAK2(V617F) allele burden in patients with PV. Furthermore, PV-related inflammation may exacerbate thrombogenesis through varied mechanisms, including endothelial damage, inhibition of natural anticoagulant pathways, and secretion of procoagulant factors. These findings suggest a direct link between myeloproliferation and thrombogenesis in PV, which is likely to provide new opportunities for targeted antithrombotic interventions aimed at decreasing PV-related morbidity and mortality.
authors.affiliation: Section of Benign Hematology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1464, Houston, TX 77030, USA. Electronic address: mkroll@mdanderson.org.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Kroll
authors.affiliation: Blood and Lymph Node Cancer Program, Division of Hematology and Oncology, Medical College of Wisconsin, Froedtert Hospital, 9200 W. Wisconsin Ave., Milwaukee, WI 53226, USA. Electronic address: lmichaelis@mcw.edu.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Michaelis
authors.affiliation: Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: sverstov@mdanderson.org.
authors.forename: Srdan
authors.initials: S
authors.lastname: Verstovsek
mesh_terms: D006801:Humans; D011087:Polycythemia Vera / Q000188:drug therapy / Q000503:physiopathology*; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology*
keywords: Janus kinase 2; Polycythemia vera; Thrombosis