Thrombosis among 1537 patients with JAK2 V617F -mutated myeloproliferative neoplasms: Risk factors and development of a predictive model

• Published in: Cancer medicine (Malden, MA) Vol. 9; no. 6; pp. 2096 - 2105
• Main Authors: Zhang, Yuhui, Zhou, Yuan, Wang, Yingshao, Teng, Guangshuai, Li, Dapeng, Wang, Yan, Du, Chenxiao, Chen, Yafang, Zhang, Huiqin, Li, Yanqi, Fu, Lixia, Chen, Kangyin, Bai, Jie
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-03-2020
• Subjects: Acute myeloid leukemia; Adolescent; Adult; Age; Age Factors; Aged; Aged, 80 and over; Alleles; Blood cancer; Blood diseases; Cardiovascular diseases; China - epidemiology; Diabetes; Disease-Free Survival; Female; Follow-Up Studies; Geriatrics; Hematology; Hospitals; Humans; Hypertension; Incidence; Janus kinase 2; Janus Kinase 2 - genetics; Male; Middle Aged; Mortality; Multivariate analysis; Mutation; Myelofibrosis; Myeloid leukemia; Polycythemia; Polycythemia vera; Polycythemia Vera - complications; Polycythemia Vera - genetics; Polycythemia Vera - mortality; Prediction models; Primary Myelofibrosis - complications; Primary Myelofibrosis - genetics; Primary Myelofibrosis - mortality; Proportional Hazards Models; Retrospective Studies; Risk Assessment - methods; Risk Factors; Survival analysis; Thrombocythemia, Essential - complications; Thrombocythemia, Essential - genetics; Thrombocythemia, Essential - mortality; Thromboembolism; Thrombosis; Thrombosis - epidemiology; Thrombosis - genetics; Tumors; Young Adult; China; myeloproliferative neoplasms; JAK2V617F; thrombosis
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.2886

To explore the risk factors of thrombosis in patients with JAK2
-mutated myeloproliferative neoplasms (MPNs), a cohort of 1537 Chinese patients with JAK2
-mutated MPN was retrospectively analyzed. The Kaplan-Meier method and multivariate Cox analysis were used to study the risk factors of thrombosis in patients with JAK2
-mutated MPN. Among the 1537 MPN patients, 931, 468, and 138 had polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), respectively. The median follow-up time was 7 years (range 1-47), and 12.8% of patients (197/1537) died during this period. A total of 16.8% (259/1399) of PV and ET patients had secondary myelofibrosis, and 2.5% (38/1537) of patients developed acute myeloid leukemia (AML). Thrombotic events occurred in 43.9% (675/1537) of patients, among which 91.4% (617/675) were arterial thrombosis and 16.6% (112/675) were venous thrombosis. The number of thrombotic events in PV, ET, and PMF patients was 439 (47.2%), 197 (42.1%) and 39 (28.2%), respectively. The multivariate analysis indicated that age ≥60 years old, HCT ≥48%, at least one cardiovascular risk factor, a history of thrombosis, and JAK2
allele burden (V617F%) ≥50% are risk factors for thrombosis in JAK2
-mutated MPN. According to the results of the multivariate analysis, a risk model of thrombosis was established and comprised low-risk (0 points), intermediate-risk (1 points) and high-risk (≥2 points) groups, among which the incidence of thrombosis was 9.1%, 33.7% and 72.9%. For elderly patients with JAK2
-mutated MPN and a history of thrombosis, reducing the V617F%, controlling HCT and preventing cardiovascular risk factors are necessary measures to prevent thrombosis.