Risk factors for myeloproliferative neoplasm bleeding
| Risk factor . | Comment . |
|---|---|
| Advanced age | Prospective PV cohort,68 retrospective study of all MPN subtypes67 |
| Disease duration | Prospective PV cohort68 |
| Splenomegaly | Odds ratio 2.24 in German prospective cohort |
| Prior thrombosis | Odds ratio 2.74 in German prospective cohort |
| Portal HTN | As in BCS and PVT, or with massive splenomegaly or hepatic extramedullary hematopoiesis |
| Prior hemorrhage | WHO-defined ET and PMF,3 as well as PV68 |
| MPN subtype | MF > ET/PV |
| Driving mutation | JAK2 V617F may associate with aVWS71 in ET |
| Unclear if risk is greater in CALR vs JAK2 V617F-positive MPNs | |
| Thrombocytosis | With or without aVWS |
| Leukocytosis | ET and early MF3 |
| aVWS | Identified even in absence of extreme thrombocytosis71 |
| Treatment | Antiplatelet therapy? |
| Anticoagulation? | |
| Antiplatelet therapy with anagrelide41 |
| Risk factor . | Comment . |
|---|---|
| Advanced age | Prospective PV cohort,68 retrospective study of all MPN subtypes67 |
| Disease duration | Prospective PV cohort68 |
| Splenomegaly | Odds ratio 2.24 in German prospective cohort |
| Prior thrombosis | Odds ratio 2.74 in German prospective cohort |
| Portal HTN | As in BCS and PVT, or with massive splenomegaly or hepatic extramedullary hematopoiesis |
| Prior hemorrhage | WHO-defined ET and PMF,3 as well as PV68 |
| MPN subtype | MF > ET/PV |
| Driving mutation | JAK2 V617F may associate with aVWS71 in ET |
| Unclear if risk is greater in CALR vs JAK2 V617F-positive MPNs | |
| Thrombocytosis | With or without aVWS |
| Leukocytosis | ET and early MF3 |
| aVWS | Identified even in absence of extreme thrombocytosis71 |
| Treatment | Antiplatelet therapy? |
| Anticoagulation? | |
| Antiplatelet therapy with anagrelide41 |
aVWS, acquired von Willebrand syndrome; BCS, Budd-Chiari syndrome; ET, essential thrombocythemia; HTN, hypertension; MF, myelofibrosis; MPN, myeloproliferative neoplasm; PMF, primary myelofibrosis; PV, polycythemia vera; PVT, portal vein thrombosis; WHO, World Health Organization.