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Prophylaxis and management of venous thromboembolism in patients with myeloproliferative neoplasms: consensus statement of the Haemostasis Working Party of the German Society of Hematology and Oncology (DGHO), the Austrian Society of Hematology and Oncology (Ă–GHO) and Society of Thrombosis and Haemostasis Research (GTH e.V.).
- Source :
-
Annals of hematology [Ann Hematol] 2014 Dec; Vol. 93 (12), pp. 1953-63. Date of Electronic Publication: 2014 Oct 14. - Publication Year :
- 2014
-
Abstract
- Patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) like polycythemia vera and essential thrombocythemia are at increased risk of arterial and venous thrombosis. Strategies of prevention may consist of platelet aggregation inhibitors and/or cytoreductive agents depending on the underlying disease and the individual risk. Clinical evidence for management of acute venous thromboembolic events in MPN patients is limited. Modality and duration of therapeutic anticoagulation after venous thrombosis has to be evaluated critically with special regard to the increased risk for spontaneous bleeding events associated with the underlying diseases. Both for therapy of the acute event and for secondary prophylaxis, low-molecular-weight heparins should preferentially be used. A prolongation of the therapeutic anticoagulation beyond the usual 3 to 6 months can only be recommended in high-risk settings and after careful evaluation of potential risks and benefits for the individual patient. New direct oral anticoagulants (NOAC) should not preferentially be used due to lack of clinical experience in patients with MPN and potential drug interactions (e.g. with JAK inhibitors). Consequent treatment of the underlying myeloproliferative disease and periodical evaluation of the response to therapy is crucial for optimal secondary prophylaxis of thromboembolic events in those patients.
- Subjects :
- Anticoagulants administration & dosage
Anticoagulants adverse effects
Anticoagulants pharmacokinetics
Disease Susceptibility
Drug Interactions
Female
Hemorrhage chemically induced
Hemorrhage prevention & control
Heparin, Low-Molecular-Weight administration & dosage
Heparin, Low-Molecular-Weight adverse effects
Heparin, Low-Molecular-Weight therapeutic use
Humans
Hydroxyurea therapeutic use
Incidence
Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative blood
Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative complications
Male
Myeloproliferative Disorders blood
Myeloproliferative Disorders therapy
Phlebotomy
Platelet Aggregation Inhibitors administration & dosage
Platelet Aggregation Inhibitors adverse effects
Platelet Aggregation Inhibitors therapeutic use
Postoperative Complications prevention & control
Pregnancy
Pregnancy Complications, Hematologic drug therapy
Pregnancy Complications, Hematologic prevention & control
Preoperative Care
Protein Kinase Inhibitors pharmacokinetics
Protein Kinase Inhibitors therapeutic use
Quinazolines therapeutic use
Secondary Prevention
Thrombophilia etiology
Venous Thromboembolism epidemiology
von Willebrand Diseases etiology
von Willebrand Diseases physiopathology
Anticoagulants therapeutic use
Myeloproliferative Disorders complications
Thrombophilia drug therapy
Venous Thromboembolism prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0584
- Volume :
- 93
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Annals of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 25307456
- Full Text :
- https://doi.org/10.1007/s00277-014-2224-8