文章：

针对骨髓增殖性肿瘤相关血栓形成管理中未满足的临床需求提出解决方案：基于共识的立场文件

Addressing and proposing solutions for unmet clinical needs in the management of myeloproliferative neoplasm-associated thrombosis: A consensus-based position paper

原文发布日期：2019-08-08

DOI: 10.1038/s41408-019-0225-5

类型: Article

开放获取: 是

英文摘要：

This article presents the results of a group discussion among an ad hoc constituted Panel of experts aimed at highlighting unmet clinical needs (UCNs) in the management of thrombotic risk and thrombotic events associated with Philadelphia-negative myeloproliferative neoplasms (Ph-neg MPNs). With the Delphi technique, the challenges in Ph-neg MPN-associated thrombosis were selected. The most clinically relevant UCNs resulted in: (1) providing evidence of the benefits and risks of direct oral anticoagulants, (2) providing evidence of the benefits and risks of cytoreduction in patients with splanchnic vein thrombosis without hypercythemia, (3) improving knowledge of the role of the mutated endothelium in the pathogenesis of thrombosis, (4) improving aspirin dosing regimens in essential thrombocythemia, (5) improving antithrombotic management of Ph-neg MPN-associated pregnancy, (6) providing evidence for the optimal duration of anticoagulation for prophylaxis of recurrent VTE, (7) improving knowledge of the association between somatic gene mutations and risk factors for thrombosis, and (8) improving the grading system of thrombosis risk in polycythemia vera. For each of these issues, proposals for advancement in research and clinical practice were addressed. Hopefully, this comprehensive overview will serve to inform the design and implementation of new studies in the field.
 

摘要翻译： 

本文介绍了一个特设专家小组的讨论结果，该讨论旨在突出费城染色体阴性骨髓增殖性肿瘤相关血栓形成风险及血栓事件管理领域中未被满足的临床需求。通过德尔菲法，筛选出费城染色体阴性骨髓增殖性肿瘤相关血栓形成领域的核心挑战。最具临床相关性的未满足需求包括：(1)提供直接口服抗凝药的获益与风险证据，(2)为无红细胞增多症的内脏静脉血栓患者提供细胞减灭术的获益与风险证据，(3)深化突变内皮在血栓形成中作用的认识，(4)优化原发性血小板增多症的阿司匹林给药方案，(5)改进费城染色体阴性骨髓增殖性肿瘤相关妊娠期的抗血栓管理，(6)确立预防静脉血栓栓塞复发的最佳抗凝疗程证据，(7)深化体细胞基因突变与血栓形成风险因素关联的认知，(8)完善真性红细胞增多症的血栓风险分级体系。针对每项议题，提出了推动科研与临床实践的具体建议。这一全面综述有望为该领域新研究的设计与实施提供参考依据。

原文链接：

Addressing and proposing solutions for unmet clinical needs in the management of myeloproliferative neoplasm-associated thrombosis: A consensus-based position paper