High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with Vitamin K antagonists

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High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with Vitamin K antagonists. / De Stefano, V.; Ruggeri, M.; Cervantes, F.; Alvarez-Larran, A.; Iurlo, A.; Randi, M. L.; Elli, E.; Finazzi, M. C.; Finazzi, G.; Zetterberg, E.; Vianelli, N.; Gaidano, G.; Rossi, E.; Betti, S.; Nichele, I.; Cattaneo, D.; Palova, M.; Ellis, M. H.; Cacciola, R.; Tieghi, A.; Hernandez-Boluda, J. C.; Pungolino, E.; Specchia, G.; Rapezzi, D.; Forcina, A.; Musolino, C.; Carobbio, A.; Griesshammer, M.; Sant'Antonio, E.; Vannucchi, A. M.; Barbui, T.

I: Leukemia, Vol. 30, Nr. 10, 01.10.2016, s. 2032-2038.

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Harvard

De Stefano, V, Ruggeri, M, Cervantes, F, Alvarez-Larran, A, Iurlo, A, Randi, ML, Elli, E, Finazzi, MC, Finazzi, G, Zetterberg, E, Vianelli, N, Gaidano, G, Rossi, E, Betti, S, Nichele, I, Cattaneo, D, Palova, M, Ellis, MH, Cacciola, R, Tieghi, A, Hernandez-Boluda, JC, Pungolino, E, Specchia, G, Rapezzi, D, Forcina, A, Musolino, C, Carobbio, A, Griesshammer, M, Sant'Antonio, E, Vannucchi, AM & Barbui, T 2016, 'High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with Vitamin K antagonists', Leukemia, vol. 30, nr. 10, s. 2032-2038. https://doi.org/10.1038/leu.2016.85

APA

De Stefano, V., Ruggeri, M., Cervantes, F., Alvarez-Larran, A., Iurlo, A., Randi, M. L., ... Barbui, T. (2016). High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with Vitamin K antagonists. Leukemia, 30(10), 2032-2038. https://doi.org/10.1038/leu.2016.85

CBE

De Stefano V, Ruggeri M, Cervantes F, Alvarez-Larran A, Iurlo A, Randi ML, Elli E, Finazzi MC, Finazzi G, Zetterberg E, Vianelli N, Gaidano G, Rossi E, Betti S, Nichele I, Cattaneo D, Palova M, Ellis MH, Cacciola R, Tieghi A, Hernandez-Boluda JC, Pungolino E, Specchia G, Rapezzi D, Forcina A, Musolino C, Carobbio A, Griesshammer M, Sant'Antonio E, Vannucchi AM, Barbui T. 2016. High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with Vitamin K antagonists. Leukemia. 30(10):2032-2038. https://doi.org/10.1038/leu.2016.85

MLA

Vancouver

Author

De Stefano, V. ; Ruggeri, M. ; Cervantes, F. ; Alvarez-Larran, A. ; Iurlo, A. ; Randi, M. L. ; Elli, E. ; Finazzi, M. C. ; Finazzi, G. ; Zetterberg, E. ; Vianelli, N. ; Gaidano, G. ; Rossi, E. ; Betti, S. ; Nichele, I. ; Cattaneo, D. ; Palova, M. ; Ellis, M. H. ; Cacciola, R. ; Tieghi, A. ; Hernandez-Boluda, J. C. ; Pungolino, E. ; Specchia, G. ; Rapezzi, D. ; Forcina, A. ; Musolino, C. ; Carobbio, A. ; Griesshammer, M. ; Sant'Antonio, E. ; Vannucchi, A. M. ; Barbui, T. / High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with Vitamin K antagonists. I: Leukemia. 2016 ; Vol. 30, Nr. 10. s. 2032-2038.

RIS

TY - JOUR

T1 - High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with Vitamin K antagonists

AU - De Stefano, V.

AU - Ruggeri, M.

AU - Cervantes, F.

AU - Alvarez-Larran, A.

AU - Iurlo, A.

AU - Randi, M. L.

AU - Elli, E.

AU - Finazzi, M. C.

AU - Finazzi, G.

AU - Zetterberg, E.

AU - Vianelli, N.

AU - Gaidano, G.

AU - Rossi, E.

AU - Betti, S.

AU - Nichele, I.

AU - Cattaneo, D.

AU - Palova, M.

AU - Ellis, M. H.

AU - Cacciola, R.

AU - Tieghi, A.

AU - Hernandez-Boluda, J. C.

AU - Pungolino, E.

AU - Specchia, G.

AU - Rapezzi, D.

AU - Forcina, A.

AU - Musolino, C.

AU - Carobbio, A.

AU - Griesshammer, M.

AU - Sant'Antonio, E.

AU - Vannucchi, A. M.

AU - Barbui, T.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - The optimal duration of treatment with vitamin K antagonists (VKA) after venous thromboembolism (VTE) in patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) is uncertain. To tackle this issue, we retrospectively studied 206 patients with MPN-related VTE (deep venous thrombosis of the legs and/or pulmonary embolism). After this index event, we recorded over 695 pt-years 45 recurrences, venous in 36 cases, with an incidence rate (IR) of 6.5 per 100 pt-years (95% confidence interval (CI): 4.9-8.6). One hundred fifty-five patients received VKA; the IR of recurrent thrombosis per 100 pt-years was 4.7 (95% CI: 2.8-7.3) on VKA and 8.9 (95% CI: 5.7-13.2) off VKA (P=0.03). In patients receiving VKA, the IR of recurrent thrombosis per 100 pt-years was 5.3 (95% CI: 3.2-8.4) among 108 patients on long-term VKA and 12.8 (95% CI: 7.3-20.7) after discontinuation among the 47 who ceased treatment (P=0.008), with a doubled risk of recurrence after stopping VKA (hazard ratio: 2.21, 95% CI: 1.19-5.30). The IR of major bleeding per 100 pt-years was 2.4 (95%: CI: 1.1-4.5) on VKA and 0.7 (95% CI: 0.08-2.5) off VKA (P=0.08). In conclusion, in MPN patients with VTE recurrent thrombosis is significantly reduced by VKA and caution should be adopted in discontinuation; however, the incidence of recurrence on treatment remains high, calling for clinical trials aimed to improve prophylaxis in this setting.

AB - The optimal duration of treatment with vitamin K antagonists (VKA) after venous thromboembolism (VTE) in patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) is uncertain. To tackle this issue, we retrospectively studied 206 patients with MPN-related VTE (deep venous thrombosis of the legs and/or pulmonary embolism). After this index event, we recorded over 695 pt-years 45 recurrences, venous in 36 cases, with an incidence rate (IR) of 6.5 per 100 pt-years (95% confidence interval (CI): 4.9-8.6). One hundred fifty-five patients received VKA; the IR of recurrent thrombosis per 100 pt-years was 4.7 (95% CI: 2.8-7.3) on VKA and 8.9 (95% CI: 5.7-13.2) off VKA (P=0.03). In patients receiving VKA, the IR of recurrent thrombosis per 100 pt-years was 5.3 (95% CI: 3.2-8.4) among 108 patients on long-term VKA and 12.8 (95% CI: 7.3-20.7) after discontinuation among the 47 who ceased treatment (P=0.008), with a doubled risk of recurrence after stopping VKA (hazard ratio: 2.21, 95% CI: 1.19-5.30). The IR of major bleeding per 100 pt-years was 2.4 (95%: CI: 1.1-4.5) on VKA and 0.7 (95% CI: 0.08-2.5) off VKA (P=0.08). In conclusion, in MPN patients with VTE recurrent thrombosis is significantly reduced by VKA and caution should be adopted in discontinuation; however, the incidence of recurrence on treatment remains high, calling for clinical trials aimed to improve prophylaxis in this setting.

UR - http://www.scopus.com/inward/record.url?scp=84966559653&partnerID=8YFLogxK

U2 - 10.1038/leu.2016.85

DO - 10.1038/leu.2016.85

M3 - Article

VL - 30

SP - 2032

EP - 2038

JO - Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K

T2 - Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K

JF - Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K

SN - 1476-5551

IS - 10

ER -