Background: Identification of JAK-2 mutation even in absence of myeloproliferative disorders was found to be related to venous thromboembolism occurrence. The aim of this work is to screen myeloproliferative neoplasm ( MPN) patients for venous thrombosis and study its correlation with both JAK 2 allele burden and with symptoms the patients presented with. Methods: We enrolled 73 cases with JAK2 positive MPN in the period between August 2015 till Feb 2017. All patients were screened for thrombosis in venous system in neck, upper and lower limbs, superior and inferior Venae Cavae and portal and mesenteric venous systems system using color Doppler Ultrasound. Results: 53 patients (72.6%) were below 60 years. Forty even (64.4%) were females and 26(35%) were males. Twenty two (30%) of cases were Essential Thrombocytosis (ET), 35(248%) were Polycythemia Vera (PV) and 16 (22%) were Myelofibrosis (MF). Twenty seven venous thrombotic attacks were reported in twenty two patients (30.1%). Seventeen patients (23%) had mesenteric and portal vein thrombosis,six patients had iliofemoral (8%) and 4 (5%) had combined lower limb and portal thrombosis. Eight patients (10.8%) had active thrombosis at screening. Only three (4%) patient were symptomatising with pain during screening. Sixteen patients with thrombosis were below 60 (30% of those below 60 years) and 6 were above sixty years (also 30% of those above sixty years). Correlation analysis between JAK2 allele burden and thrombosis was not statistically significant (r=0.3 ,p value=0.5). However, JAK 2 allele burden was statistically higher in those above sixty years in both thrombosed and non-thrombosed cases in comparison to those below sixty years (p= 0.03, 0.017 respectively). The incidence of pruritis (p =0.02) and of abdominal pain (p=0.039) was significantly different between thrombosed and non-thrombosed cases. Comparison of 8 cases with active thrombosis to old thrombosis revealed no statistical difference in the MPN10 score (p>0.05). Conclusion: We recommend routine screen for venous thrombosis in any case of MPNs once diagnosed and screening for MPNs in any case with venous thrombosis . Further research in MPN group age below 60 years of age is highly recommended.

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Disclosures

No relevant conflicts of interest to declare.

Topics:
myeloproliferative disease, thrombosis, screening, venous thrombosis, abdominal pain, doppler color flow, doppler echocardiography, myelofibrosis, pain, polycythemia vera

Author notes

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Asterisk with author names denotes non-ASH members.

© 2018 by The American Society of Hematology
2018
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