Clinical Features of 294 Turkish Patients with Chronic Myeloproliferative Neoplasms.
OBJECTIVE
Myeloproliferative neoplasms (MPNs) share common clonal stem cells but show significant differences in their clinical courses. The aim of this retrospective study was to evaluate thrombotic and hemorrhagic complications, JAK2 status, gastrointestinal and cardiac changes, treatment modalities, and survival in MPNs in Turkish patients.


METHODS
Medical files of 294 patients [112 essential thrombocythemia (ET), 117 polycythemia vera (PV), 46 primary myelofibrosis, and 19 unclassified MPN cases] from 2 different universities in Turkey were examined.


RESULTS
Older age, higher leukocyte count at diagnosis, and JAK2 mutation positivity were risk factors for thrombosis. Platelet count over 1000x109/L was a risk factor for hemorrhagic episodes. Hydroxyurea treatment was not related to leukemic transformation. Median follow-up time was 50 months (quartiles: 22.2-81.75) in these patients. Patients with primary myelofibrosis had the shortest survival of 137 months when compared with 179 months for ET and 231 months for PV. Leukemic transformation, thromboembolic events, age over 60 years, and anemia were found to be the factors affecting survival.


CONCLUSIONS
Thromboembolic complications are the most important preventable risk factors for morbidity and mortality in MPNs. Drug management in MPNs is done according to hemoglobin and platelet counts. Based on the current study population our results support the idea that leukocytosis and JAK2 positivity are more important risk factors for thrombosis than hemoglobin and platelet values.
Osmangazi University Faculty of Medicine, Department of Hematology, Eskişehir, Turkey, Phone: +90 532 518 22 63, E-mail: neslihandic@yahoo.com.
Neslihan
N
Andıç
Mustafa
M
Ünübol
Eren
E
Yağcı
Olga Meltem
OM
Akay
İrfan
İ
Yavaşoğlu
Vefki Gürhan
VG
Kadıköylü
Ali Zahit
AZ
Bolaman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006470:Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D053614:Janus Kinase 2 / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009196:Myeloproliferative Disorders / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D011799:Quinazolines / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey; D054556:Venous Thromboembolism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
D011799:Quinazolines; D053614:Janus Kinase 2; C021139:anagrelide; D006918:Hydroxyurea