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Anticoagulation for splanchnic vein thrombosis in myeloproliferative neoplasms : a systematic review and meta-analysis

Chrysafi, Pavlina ; Barnum, Kevin ; Gerhard, Genevieve M. ; Chiasakul, Thita ; Narang, Arshit ; Mcnichol, Megan ; Riva, Nicoletta ; Semmler, Georg ; Scheiner, Bernhard and Acosta, Stefan LU orcid , et al. (2024) In Journal of Thrombosis and Haemostasis 22(12). p.3479-3489
Abstract

Background: Optimal anticoagulation management in patients with myeloproliferative neoplasms (MPN) experiencing splanchnic vein thrombosis (SpVT) requires balancing risks of bleeding and recurrent thrombosis. Objectives: We conducted a systematic review and meta-analysis to assess the incidence of bleeding and thrombosis recurrence in patients with MPN-SpVT. Methods: We included retrospective or prospective studies in English with ≥10 adult patients with MPN-SpVT. Outcomes included recurrent venous thrombosis (SpVT and non-SpVT), arterial thrombosis, and major bleeding. Pooled rates per 100 patient years with 95% CIs were calculated by DerSimonian–Laird method using random-effects model. Results: Out of 4624 studies screened, 9 studies... (More)

Background: Optimal anticoagulation management in patients with myeloproliferative neoplasms (MPN) experiencing splanchnic vein thrombosis (SpVT) requires balancing risks of bleeding and recurrent thrombosis. Objectives: We conducted a systematic review and meta-analysis to assess the incidence of bleeding and thrombosis recurrence in patients with MPN-SpVT. Methods: We included retrospective or prospective studies in English with ≥10 adult patients with MPN-SpVT. Outcomes included recurrent venous thrombosis (SpVT and non-SpVT), arterial thrombosis, and major bleeding. Pooled rates per 100 patient years with 95% CIs were calculated by DerSimonian–Laird method using random-effects model. Results: Out of 4624 studies screened, 9 studies with a total of 443 patients were included in the meta-analysis with median follow-up of 3.5 years. In the 364 patients with MPN-SpVT treated with anticoagulation, pooled event rate for major bleeding was 2.8 (95% CI, 1.5-5.1; I2 = 95%), for recurrent venous thrombosis was 1.4 (95% CI, 0.8–2.2; I2 = 72%), and for arterial thrombosis was 1.4 (95% CI, 0.6-3.3; I2 = 92%) per 100 patient years. Among 79 patients (n = 4 studies) who did not receive anticoagulation, pooled event rate for major bleeding was 3.2 (95% CI, 0.7-12.7; I2 = 97%), for recurrent venous thrombosis 3.5 (95% CI, 1.8-6.4; I2 = 88%), and for arterial thrombosis rate 1.6 (95% CI, 0.4-6.6; I2 = 95%) per 100 patient years. Conclusion: Patients with MPN-SpVT treated with anticoagulation have significant risks for both major bleeding and thrombosis recurrence. Further studies are necessary to determine the optimal anticoagulation approach in patients with MPN-SpVT.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anticoagulants, bleeding, myeloproliferative disorders, thrombosis
in
Journal of Thrombosis and Haemostasis
volume
22
issue
12
pages
11 pages
publisher
Elsevier
external identifiers
  • pmid:39127323
  • scopus:85202734088
ISSN
1538-7933
DOI
10.1016/j.jtha.2024.06.029
language
English
LU publication?
yes
id
7f87b892-7543-4950-83ae-322bc080df2d
date added to LUP
2024-12-13 14:14:34
date last changed
2025-07-26 08:20:15
@article{7f87b892-7543-4950-83ae-322bc080df2d,
  abstract     = {{<p>Background: Optimal anticoagulation management in patients with myeloproliferative neoplasms (MPN) experiencing splanchnic vein thrombosis (SpVT) requires balancing risks of bleeding and recurrent thrombosis. Objectives: We conducted a systematic review and meta-analysis to assess the incidence of bleeding and thrombosis recurrence in patients with MPN-SpVT. Methods: We included retrospective or prospective studies in English with ≥10 adult patients with MPN-SpVT. Outcomes included recurrent venous thrombosis (SpVT and non-SpVT), arterial thrombosis, and major bleeding. Pooled rates per 100 patient years with 95% CIs were calculated by DerSimonian–Laird method using random-effects model. Results: Out of 4624 studies screened, 9 studies with a total of 443 patients were included in the meta-analysis with median follow-up of 3.5 years. In the 364 patients with MPN-SpVT treated with anticoagulation, pooled event rate for major bleeding was 2.8 (95% CI, 1.5-5.1; I<sup>2</sup> = 95%), for recurrent venous thrombosis was 1.4 (95% CI, 0.8–2.2; I<sup>2</sup> = 72%), and for arterial thrombosis was 1.4 (95% CI, 0.6-3.3; I<sup>2</sup> = 92%) per 100 patient years. Among 79 patients (n = 4 studies) who did not receive anticoagulation, pooled event rate for major bleeding was 3.2 (95% CI, 0.7-12.7; I<sup>2</sup> = 97%), for recurrent venous thrombosis 3.5 (95% CI, 1.8-6.4; I<sup>2</sup> = 88%), and for arterial thrombosis rate 1.6 (95% CI, 0.4-6.6; I<sup>2</sup> = 95%) per 100 patient years. Conclusion: Patients with MPN-SpVT treated with anticoagulation have significant risks for both major bleeding and thrombosis recurrence. Further studies are necessary to determine the optimal anticoagulation approach in patients with MPN-SpVT.</p>}},
  author       = {{Chrysafi, Pavlina and Barnum, Kevin and Gerhard, Genevieve M. and Chiasakul, Thita and Narang, Arshit and Mcnichol, Megan and Riva, Nicoletta and Semmler, Georg and Scheiner, Bernhard and Acosta, Stefan and Rautou, Pierre Emmanuel and Lauw, Mandy N. and Berry, Jonathan and Ageno, Walter and Zwicker, Jeffrey I. and Patell, Rushad}},
  issn         = {{1538-7933}},
  keywords     = {{anticoagulants; bleeding; myeloproliferative disorders; thrombosis}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{3479--3489}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Thrombosis and Haemostasis}},
  title        = {{Anticoagulation for splanchnic vein thrombosis in myeloproliferative neoplasms : a systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1016/j.jtha.2024.06.029}},
  doi          = {{10.1016/j.jtha.2024.06.029}},
  volume       = {{22}},
  year         = {{2024}},
}