Among classic myeloproliferative neoplasms, essential thrombocythemia is associated with the greatest risk of venous thromboembolism during COVID-19

Author:

Barbui TizianoORCID,De Stefano ValerioORCID,Alvarez-Larran Alberto,Iurlo AlessandraORCID,Masciulli Arianna,Carobbio AlessandraORCID,Ghirardi Arianna,Ferrari Alberto,Cancelli Valeria,Elli Elena Maria,Andrade-Campos Marcio Miguel,Kabat Mercedes Gasior,Kiladjian Jean-Jaques,Palandri FrancescaORCID,Benevolo Giulia,Garcia-Gutierrez ValentinORCID,Fox Maria Laura,Foncillas Maria AngelesORCID,Morcillo Carmen Montoya,Rumi ElisaORCID,Osorio Santiago,Papadopoulos Petros,Bonifacio MassimilianoORCID,Cervantes Keina Susana QuirozORCID,Serrano Miguel Sagues,Carreno-Tarragona GonzaloORCID,Sobas Marta Anna,Lunghi Francesca,Patriarca Andrea,Elorza Begoña Navas,Angona Anna,Mazo Elena Magro,Koschmieder SteffenORCID,Carli Giuseppe,Cuevas BeatrizORCID,Hernandez-Boluda Juan CarlosORCID,Abadia Emma Lopez,Cirici Blanca Xicoy,Guglielmelli PaolaORCID,Garrote Marta,Cattaneo Daniele,Daffini Rosa,Cavalca Fabrizio,Bellosillo Beatriz,Benajiba Lina,Curto-Garcia Natalia,Bellini Marta,Betti Silvia,Harrison Claire,Rambaldi AlessandroORCID,Vannucchi Alessandro Maria

Abstract

AbstractIn 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.

Funder

Funder: Brembo SpA, grant: Brembo "3x1 project"

Funder: AIRC, Grant: MYNERVA project, #21267

Publisher

Springer Science and Business Media LLC

Subject

Oncology,Hematology

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