Challenges in predicting hydroxyurea resistance and reducing thrombotic risk in polycythemia vera patients: unmasking the limits of its machine learning study.

Cytokine profiles in polycythemia vera and essential thrombocythemia patients: Clinical implications

The Impact of the 2011 European Leukemianet (ELN) Guidelines for Philadelphia Chromosome-Negative Classical Myeloproliferative Neoplasms on Therapeutic Phlebotomy and Hydroxyurea Use in Patients with Polycythemia Vera and Essential Thrombocythemia

Impact of V617F JAK2 Mutation on Monocyte Tissue Factor and Procoagulant Activity in Patients with Essential Thrombocythemia(ET) or Polycythemia VERA (PV)

Iron Deficiency Significantly Contributes to Thrombotic Risk and to the Risk of Myelofibrotic Transformation in PV and ET Patients

Upregulation of Thrombo-Inflammatory Pathways May Contribute to Increased Thrombotic Risk in Polycythemia Vera and Essential Thrombocythemia

Gene Expression Profiling Distinguishes Essential Thrombocythemia from Polycythemia Vera Patients and Identifies a Common Expressed Set of Genes in Relation to JAK2V617F Status

e18599 Background: Polycythemia vera (PCV) is a myeloproliferative neoplasm defined by the clonal proliferation of hematopoietic progenitor cells. PCV is associated with an increased risk of thrombosis, which is stratified according to patient age and thrombosis history. Secondary malignancies (SM) develop in 8.4% of PCV patients. While cancer-associated thrombosis is an evolving field, the risk of thrombosis among PCV patients with SM is not well described. Methods: This study is a secondary analysis of data from a previously conducted study approved by the University of Illinois College of Medicine Peoria IRB. We identified 145 JAK2-positive adult patients (2015 - 2024) with elevated hemoglobin (≥160 g/L for females, ≥165 g/L for males) and no cancer history prior to PCV diagnosis. The relative risk (RR) of venous and arterial thrombosis among patients with SM compared to those without SM was calculated. Results: The rate of SM was 238.0 per 1000 person-years, with Myelodysplastic Disease (55.8%), Myeloid Leukemia (11.5%) and Lung Cancer (9.6%) being the most common. There were no statistically significant differences in age, gender and race between patients who developed SM compared to those who did not. Patients with SM had a greater overall risk of arterial (RR: 1.11, 95% CI: 1.09 - 1.13) and venous thrombosis (RR: 1.09, 95% CI: 1.07 - 1.10), as shown in Table 1. PCV patients with SM were less likely to have pulmonary embolisms (PE) (RR: 0.79, 95% CI: 0 0.78 - 0.81). Conclusions: This study demonstrated an anticipated increased risk of thrombosis among PCV patients with SM, except for PE. However, this study did not compare thrombotic risk factors, rates of PCV treatment, or details of individual clotting events between groups. This analysis is also limited by a small sample size. Future studies should evaluate the risks and benefits of antithrombotic prophylaxis among PCV patients with SM. Providers could consider these findings when stratifying the risk of thrombosis and individualizing treatment decisions. The incidence and relative risk of thrombosis among Polycythemia Vera (PCV) patients with secondary malignancies (SM) compared to those with Polycythemia Vera only. PCV with SM (n/1000 person years) PCV only (n/1000 person years) Relative Risk 95% Confidence Interval Arterial Thrombosis 278.49 251.09 1.11 1.09, 1.13 STEMI/NSTEMI 282.87 229.27 1.23 1.22, 1.25 TIA/CVA 276.73 255.96 1.08 1.07, 1.10 Venous Thrombosis 291.99 268.63 1.09 1.07, 1.10 DVT 309.30 273.68 1.13 1.11, 1.15 PE 201.71 254.53 0.79 0.78, 0.81 Thrombosis incidence is expressed per 100,000 person-years. CI: 95% Confidence Interval; DVT: Deep Vein Thrombosis; NSTEMI: Non-ST-Elevation Myocardial Infarction; PE: Pulmonary Embolism; RR: PCV: Polycythemia Vera; Relative Risk; SM: Secondary Malignancies; STEMI: ST-Elevation Myocardial Infarction; TIA/CVA: Transient Ischemic Attack/Cerebrovascular Accident.

To analyze the occurrence of arterial events and platelet parameters in patients with polycythemia vera (PV) and essential thrombocythemia (ET), and to explore the characteristics of platelet parameters in patients with PV and ET and their relationship with arterial complications. The clinical and laboratory data of newly diagnosed PV and ET patients who visited the Department of Hematology, Beijing Anzhen Hospital, Capital Medical University from August 2017 to August 2022 were retrospectively analyzed. 86 MPN patients (46 males and 40 females) were enrolled, including 44 PV patients and 42 ET patients, with an median age of 61(23-83) years. The mutation rate of JAK2V617F gene, the number of megakaryocytes in bone marrow, the incidence of splenomegaly, and the levels of white blood cell count (WBC), hemoglobin (HGB), hematocrit (HCT), platelet distribution width (PDW), mean platelet volume (MPV), platelet-large cell ratio (P-LCR) in PV patients were significantly higher than those in ET patients (P < 0.05), while the levels of PLT and PCT were significantly lower than those in ET patients (P < 0.01). 22 cases (50%) of PV patients were complicated with arterial events, of which 12 had arterial stenosis in≥2 locations. Among arterial events, the PDW of PV patients with ischemic stroke was greater than that of PV patients without ischemic stroke (P =0.003), and the PDW of PV patients with arterial stenosis in≥2 locations was greater than that of PV patients with arterial stenosis in≤1 location (P =0.037). 23 cases (54.8%) of ET patients were complicated with arterial events, and 7 cases had arterial stenosis in≥2 locations. In arterial events, the PCT of ET patients complicated with ischemic stroke was greater than that of ET patients without ischemic stroke (P =0.037), and the PCT of ET patients with≥2 locations of arterial stenosis was greater than that of ET patients with≤1 location of arterial stenosis (P =0.049). The binary logistic regression analysis showed that elevated PDW and PCT were risk factors for ischemic stroke in PV and ET patients, respectively (P < 0.05). The platelet parameters of PV and ET patients exhibit significantly different characteristics. Elevated PDW and PCT can predict a higher risk of ischemic stroke in PV and ET patients, respectively.

The Study of Thrombosis in Polycythemia Vera

The Influence of Hemostasis Genetic Features on Thrombosis Rates in Patients with Polycythemia Vera

A Phase 3 Study of the Hepcidin Mimetic Rusfertide (PTG-300) in Patients with Polycythemia Vera

PTG-300 Eliminates the Need for Therapeutic Phlebotomy in Both Low and High-Risk Polycythemia Vera Patients

Factors related to the development of acquired von Willebrand syndrome in patients with essential thrombocythemia and polycythemia vera

The article deals with determining possibility of the assessment of the level of endogenous serum erythropoietin (EPO) for differential diagnosis of polycythemia vera (PV) and secondary erythrocytosis (SE). The determination of subnormal level of this cytokine for the diagnosis of PV has been detected. The relation between the level of endogenous erythropoietin and iron metabolism also has been analyzed. The study involved 88 patients with PV and 119 patients with SE. Statistically significant decrease in EPO concentration level has been detected in PV patients. The mean EPO level was equal to 6.38 ± 0.84 mIU/mL and 17.98 ±2.48 mIU/mL in PV and SE patients respectively. In control group of individuals EPO concentration was equal to 9,81 ±0,58 mIU/mL, the significant difference was found between all studied groups (р<0.01). According to our data, EPO was increased in 28 SE patients (23.53%), it was not observed in control group and in group of PV patients (φ*emp = 4.355, р<0.01). The decrease of EPO level in PV patients has been detected more often than in SE patients (84.09% versus 11.76% , φ*emp = 5.218, р<0.01), it has not been observed in control group. Only 14 (15.91%) PV patients had normal EPO level, in contrast 77 (64.71%) SE patients demonstrated normal EPO level (φ*emp = 4.578, р<0.01). The average level of ferritin was equal to 57.41 ± 9.74 ng/mL in PV patients and 199.77 ± 14.32 ng/mL in SE patients (р<0.01). Significantly more patients with PV demonstrated decrease of ferritin level (31.81% versus 7.56%, φ*emp = 4.438, р<0.01). Patients with SE more often had raised level of EPO than PV patients (15.12% versus 4.54%, φ*emp = 2.453, р<0.01). The sensitivity of test with detecting of the reduced level of EPO for the diagnosis of PV was 84.1%, specificity - 87.4%, positive predictive value - 83.1%, negative predictive value - 88.1%. Normal range of EPO significantly (rs = 0,5494) correlated with decreased levels of serum ferritin in patients with polycythemia vera, which was caused by iron deficiency in a certain number of patients with PV.

miRNAs Expression Pattern in Essential Thrombocythemia and Polycythemia Vera Patients.