title: Bleeding complications in BCR-ABL negative myeloproliferative neoplasms: prevalence, type, and risk factors in a single-center cohort.
abstract: The BCR-ABL1-negative myeloproliferative neoplasms (MPN) share an increased risk of thrombotic and hemorrhagic complications. Risk factors for hemorrhage are less well defined than those for thrombosis. Because patients with CALR mutations have higher platelet counts compared to JAK2 V617F-mutated patients, bleeding rates may be increased in this group. Our aim was to retrospectively evaluate whether acquired von Willebrand disease (AvWD), thrombocytosis, mutational status, or treatment history are associated with bleeding in a cohort of MPN patients. Using an electronic database, MPN patients seen between 2005 and 2013 were retrospectively identified using ICD-9 codes and billing records. A bleeding event was defined as one that was identified in the medical record and graded based on the Common Terminology Criteria for Adverse Event (CTCAE) version 4.0. Among 351 MPN patients, 15.6 % experienced 64 bleeding event types. There was no association of bleeding with mutational status, gender, MPN subtype, aspirin use, prior thrombosis, or platelet count at presentation. There was an association between bleeding and older age at diagnosis. aVWD was identified in six patients. In this single-center retrospective study, bleeding events were identified in 15 % of patients, and associated with older age at diagnosis. aVWD was rarely tested for in this cohort.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 1020, Chicago, IL, 60611, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Kander
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 1020, Chicago, IL, 60611, USA.
authors.forename: Sania
authors.initials: S
authors.lastname: Raza
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, USA.
authors.forename: Juehua
authors.initials: J
authors.lastname: Gao
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 1020, Chicago, IL, 60611, USA.
authors.forename: Anaadriana
authors.initials: A
authors.lastname: Zakarija
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 1020, Chicago, IL, 60611, USA.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: McMahon
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 1020, Chicago, IL, 60611, USA. bstein@nm.org.
authors.forename: Brady L
authors.initials: BL
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage; D005260:Female; D016044:Fusion Proteins, bcr-abl; D006470:Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D053614:Janus Kinase 2 / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D020125:Mutation, Missense; D009196:Myeloproliferative Disorders / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D010976:Platelet Count; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D016044:Fusion Proteins, bcr-abl; C507924:JAK2 protein, human; D053614:Janus Kinase 2; D001241:Aspirin
keywords: Bleeding; Calreticulin mutations; Essential thrombocytosis; Myelofibrosis; Polycythemia vera