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01-12-2014 | Review Article

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 (ÖGHO) and Society of Thrombosis and Haemostasis Research (GTH e.V.)

Authors: Stephan Kreher, Sebastian Ochsenreither, Ralf U. Trappe, Ingrid Pabinger, Frauke Bergmann, Petro E. Petrides, Steffen Koschmieder, Axel Matzdorff, Andreas Tiede, Martin Griesshammer, Hanno Riess

Published in: Annals of Hematology | Issue 12/2014

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.

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Title: 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 (ÖGHO) and Society of Thrombosis and Haemostasis Research (GTH e.V.)
Authors: Stephan Kreher
Sebastian Ochsenreither
Ralf U. Trappe
Ingrid Pabinger
Frauke Bergmann
Petro E. Petrides
Steffen Koschmieder
Axel Matzdorff
Andreas Tiede
Martin Griesshammer
Hanno Riess
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: Annals of Hematology / Issue 12/2014
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-014-2224-8

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