Splanchnic vein thrombosis associated with myeloproliferative neoplasms.

Splanchnic vein thrombosis (SVT) in the setting of myeloproliferative neoplasm (MPN) is a unique clinical entity that requires close interdisciplinary coordination for proper diagnosis and management. The pathobiology of MPN-SVT is not fully understood, but recent developments have revealed the central role of endothelial cells. In this multidisciplinary review, we summarize the epidemiology of MPN-SVT and then critically evaluate the pathogenic features of this complication, with a focus on endothelial cell biology. We then discuss diagnostic considerations, including imaging modalities and MPN-specific investigations. Finally, we critically review the evidence supporting clinical management of MPN-SVT, including anticoagulation, interventional radiology procedures, MPN-related therapies, and liver transplantation. We conclude that further studies are needed to improve our understanding of MPN-SVT and the outcomes of patients with this debilitating complication.
Competing Interests: Declaration of competing interest DT receives research clinical research funding from Astellas Pharma and consulting fees from AbbVie and CTI Biopharma. JDB receives research funding from Bayer independent of studies herein. RP receives consultancy fees from Sirtex Medical and is on the advisory boards of Medtronic, Blackswan Medical, and Scientia Inc. and is on the speakers' bureau of Medtronic. JM receives clinical research funding from Incyte, Janssen, CTI Biopharma, PharmaEssentia, Novartis, Roche, Kartos, Promedior Merck and consulting fees from Promedior, Prelude, Galecto, Incyte, Celgene, Kartos, and Geron. The rest of the authors have no financial conflicts of interest to disclose.
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