Among classic myeloproliferative neoplasms, essential thrombocythemia is associated with the greatest risk of venous thromboembolism during COVID-19
Barbui, Tiziano (Papa Giovanni XXIII Hospital. FROM Research Foundation)
De Stefano, Valerio (Fondazione Policlinico "A. Gemelli" IRCCS. Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University)
Alvarez-Larran, Alberto (Hospital Clínic i Provincial de Barcelona)
Iurlo, Alessandra (Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico. Hematology Division)
Masciulli, Arianna (Papa Giovanni XXIII Hospital. FROM Research Foundation)
Carobbio, Alessandra (Papa Giovanni XXIII Hospital. FROM Research Foundation)
Ghirardi, Arianna (Papa Giovanni XXIII Hospital. FROM Research Foundation)
Ferrari, Alberto (Papa Giovanni XXIII Hospital. FROM Research Foundation)
Cancelli, Valeria (Spedali Civili)
Elli, Elena Maria (Ospedale San Gerardo (Itàlia))
Andrade-Campos, Marcio Miguel (Institut Hospital del Mar d'Investigacions Mèdiques)
Kabat, Mercedes Gasior (Hospital Universitario La Paz (Madrid))
Kiladjian, Jean-Jaques (Hospital Saint-Louis)
Palandri, Francesca (Azienda Ospedaliero-Universitaria di Bologna)
Benevolo, Giulia (AOU Città della Salute e della Scienza di Torino)
Garcia-Gutierrez, Valentin (Hospital Universitario Ramón y Cajal (Madrid))
Fox, Maria Laura (Vall d'Hebron Institut d'Oncologia)
Foncillas, Maria Angeles (Hospital Universitario Infanta Leonor)
Morcillo, Carmen Montoya (Complejo Hospitalario Universitario de Albacete)
Rumi, Elisa (University of Pavia. Department of molecular medicine)
Osorio, Santiago (Hospital General Universitario Gregorio Marañón)
Papadopoulos, Petros (Hospital Clínico San Carlos (Madrid))
Bonifacio, Massimiliano (Ospedale Policlinico "G.B. Rossi", Borgo Roma)
Quiroz Cervantes, Keina (Hospital Universitario de Móstoles (Madrid))
Serrano, Miguel Sagues (Hospital de Sant Joan Despí Moisès Broggi)
Carreño-Tarragona, Gonzalo (Hospital Universitario 12 de Octubre (Madrid))
Sobas, Marta Anna (Wroclaw Medical University. Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation)
Lunghi, Francesca (IRCCS Ospedale San Raffaele)
Patriarca, Andrea (AOU Maggiore della Carità, Novara, Italy)
Elorza, Begoña Navas (Hospital Moncloa, Madrid, Spain)
Angona, Anna (Hospital Universitari de Girona Doctor Josep Trueta)
Mazo, Elena Magro (Hospital Universitario Príncipe de Asturias (Alcalá de Henares, Madrid))
Koschmieder, Steffen (RWTH Aachen University. Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine)
Carli, Giuseppe (Ospedale San Bortolo)
Cuevas, Beatriz (Hospital Universitario de Burgos)
Hernandez-Boluda, Juan Carlos (Hospital Clínic Universitari (València))
Abadia, Emma Lopez (Hospital General Universitario de Elche)
Xicoy, Blanca (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Guglielmelli, Paola (University of Florence. Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, Azienda Ospedaliera Universitaria Careggi)
Garrote, Marta (Hospital Clínic i Provincial de Barcelona)
Cattaneo, Daniele (Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico. Hematology Division)
Daffini, Rosa (Spedali Civili)
Cavalca, Fabrizio (Ospedale San Gerardo (Itàlia))
Bellosillo Paricio, Beatriz (Institut Hospital del Mar d'Investigacions Mèdiques)
Benajiba, Lina (Hospital Saint-Louis)
Curto-Garcia, Natalia (Guy's and St. Thomas' NHS Foundation Trust)
Bellini, Marta (ASST Papa Giovanni XXIII, Bergamo, Italy)
Betti, Silvia (Fondazione Policlinico "A. Gemelli" IRCCS. Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University)
Harrison, Claire (Guy's and St. Thomas' NHS Foundation Trust)
Rambaldi, Alessandro (Università degli Studi di Milano)
Vannucchi, Alessandro Maria (University of Florence. Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, Azienda Ospedaliera Universitaria Careggi)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	In a multicenter European retrospective study including 162 patients with COVID-19 occurring in essential thrombocythemia (ET, n = 48), polycythemia vera (PV, n = 42), myelofibrosis (MF, n = 56), and prefibrotic myelofibrosis (pre-PMF, n = 16), 15 major thromboses (3 arterial and 12 venous) were registered in 14 patients, of whom all, but one, were receiving LMW-heparin prophylaxis. After adjustment for the competing risk of death, the cumulative incidence of arterial and venous thromboembolic events (VTE) reached 8. 5% after 60 days follow-up. Of note, 8 of 12 VTE were seen in ET. Interestingly, at COVID-19 diagnosis, MPN patients had significantly lower platelet count (p < 0. 0001) than in the pre-COVID last follow-up. This decline was remarkably higher in ET (−23. 3%, p < 0. 0001) than in PV (−16. 4%, p = 0. 1730) and was associated with higher mortality rate (p = 0. 0010) for pneumonia. The effects of possible predictors of thrombosis, selected from those clinically relevant and statistically significant in univariate analysis, were examined in a multivariate model. Independent risk factors were transfer to ICU (SHR = 3. 73, p = 0. 029), neutrophil/lymphocyte ratio (SHR = 1. 1, p = 0. 001) and ET phenotype (SHR = 4. 37, p = 0. 006). The enhanced susceptibility to ET-associated VTE and the associated higher mortality for pneumonia may recognize a common biological plausibility and deserve to be delved to tailor new antithrombotic regimens including antiplatelet drugs.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Risk factors ; Myeloproliferative disease ; Infectious diseases
Publicat a:	Blood Cancer Journal, Vol. 11 (february 2021) , ISSN 2044-5385

DOI: 10.1038/s41408-021-00417-3
PMID: 33563901

11 p, 1.4 MB

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