Research Reveals Distinct Risk Factors for Arterial and Venous Thrombotic Events in MPN

A study presented at the 2022 American Society of Hematology Annual Meeting aimed to elucidate clinical and molecular risk factors for arterial or venous thrombotic events in patients with myeloproliferative neoplasms (MPNs).

“Arterial and venous thrombotic events are the major complications of MPN, responsible for a high rate of morbidity and mortality. Risk stratification and prediction of these events remain challenging clinical questions,” wrote the authors, led by Hélène Pasquer, MSc, of the Institut de Recherche Saint-Louis and the Centre d’Investigations Cliniques at Hôpital Saint-Louis, both in Paris, France. “If further validated on external cohorts, our findings warrant consideration of arterial and venous thrombosis separately for future scoring systems and preventive treatment recommendations.”

The researchers examined a group of 1,055 patients with MPN who were followed at their center from 2011 to 2021. Of those, 115 (11%) presented with arterial thrombotic events, and 146 (14%) presented with venous thrombotic events before MPN diagnosis or at diagnosis. In addition, within a median follow-up of 9.45 years, 72 patients experienced arterial thrombotic events, and 79 had venous thrombotic events. The most common events were acute myocardial infarction (32%), stroke (27%), transient ischemic attack (24%), splanchnic thrombosis (37%), and deep vein thrombosis (28%).

The authors discovered that several factors were independently associated with arterial thrombotic events:

• Prior arterial thrombotic events
• Age older than 60 years at diagnosis
• Presence of cardiovascular risk factors
• Presence of TET2 or DNMT3A mutations

They then developed an arterial thrombosis risk score based on those four factors to identify low- and high-risk patients, and their tool performed better than the European Leukemia Net (ELN) risk-prediction score.

The team also found that two factors were independently associated with venous thrombotic events: prior venous thrombotic events and presence of a JAK2V617F driver mutation. Again, the researchers developed a venous thrombosis risk score based on those two factors, which performed similarly to the ELN tool.

Reference

Pasquer H, De Oliveira RD, Soret J, et al. Distinct clinico-molecular arterial and venous thrombotic scoring systems for MPN patients risk stratification. Abstract #341. Presented at the 64th American Society of Hematology Annual Meeting, December 10-13, 2022; New Orleans, Louisiana.