Study IDs Risk Factors for Thrombosis, Major Bleeding in Myelofibrosis

There are several risk factors for thrombosis and major bleeding in patients with myelofibrosis, according to a recent study.

Juan-Carlos Hernández-Boluda, MD, PhD, of the Hospital Clínico Universitario-INCLIVA in Valencia, Spain, and colleagues conducted the research because “available data have proved insufficient to develop consensus recommendations on the prevention of thrombosis and bleeding in myelofibrosis.”

They evaluated the incidence of vascular complications and risk factors in 1,613 patients from the Spanish Myelofibrosis Registry.

Dr. Hernández-Boluda and colleagues found 6.4% of the patients had at least one thrombotic event after receiving a myelofibrosis diagnosis. The incidence rate was 1.65 thrombotic events per 100 patient years over a total of 6,981 patient years at risk.

Characteristics conferring an increased thrombotic risk after adjusting for risk-modifying effects of anti-thrombotic and cytoreductive treatments were a prior history of thrombosis, a JAK2 mutation, and an International Prognostic Scoring System classification of intermediate-2/high-risk disease. Treatment with immunomodulatory agents was associated with an increased risk of venous thrombosis.

“History of thrombosis and the JAK2 mutation allowed us to pinpoint a group of patients at higher risk of early thrombosis,” Dr. Hernández-Boluda and colleagues wrote. “No decreased incidence of thrombosis was observed while patients were on anti-thrombotic or cytoreductive treatment.”

At least one episode of major bleeding occurred in 5.3% of patients, with an incidence rate of 1.5 major bleeding events per 100 patient years. Patients with intermediate-2/high-risk disease who received anti-coagulants had an almost sevenfold increased risk of major bleeding.

“These findings should prove useful for guiding decision-making in clinical practice,” Dr. Hernández-Boluda and colleagues concluded.

Reference

Hernández-Boluda JC, Pastor-Galán I, Arellano-Rodrigo E, et al. Predictors of thrombosis and bleeding in 1613 myelofibrosis patients from the Spanish Registry of Myelofibrosis. Br J Haematol. 2022. doi:10.1111/bjh.18440