文章：

骨髓增殖性肿瘤中的血栓形成：其对骨髓纤维化、死亡率和实体瘤影响的观点

Thrombosis in myeloproliferative neoplasms: a viewpoint on its impact on myelofibrosis, mortality, and solid tumors

原文发布日期：2024-10-25

DOI: 10.1038/s41408-024-01169-6

类型: Review Article

开放获取: 是

英文摘要：

This viewpoint summarizes findings from analyses of large personal patient databases of myeloproliferative neoplasms (MPNs) to assess the impact of thrombosis on mortality, disease progression, and second cancers (SC). Despite advances, the current incidence of arterial and venous thrombosis remains a challenge. These events appear to signal a more aggressive disease course, as evidenced by their association with myelofibrosis progression and mortality using multistate models and time-dependent multivariable analysis. Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), are associated with the aggressiveness of polycythemia vera (PV) and essential thrombocythemia (ET), linking thrombosis to SC risk. This suggests a common inflammatory pathway likely influencing cardiovascular disease and cancer incidence. Notably, this is observed more frequently in younger patients, likely due to prolonged exposure to MPN and environmental inflammatory triggers. These data underscore the need for new studies to validate these associations, delineate the sequence of events, and identify therapeutic targets to mitigate thrombotic events and potentially improve overall patient outcomes in MPN.
 

摘要翻译： 

本观点总结了针对骨髓增殖性肿瘤（MPN）大型患者个人数据库的分析结果，旨在评估血栓形成对死亡率、疾病进展及继发癌症（SC）的影响。尽管治疗有所进展，当前动静脉血栓形成的发生率仍是一个挑战。这些事件似乎预示着更具侵袭性的病程，多状态模型和时变性多变量分析显示，其与骨髓纤维化进展和死亡率密切相关。炎症生物标志物如中性粒细胞-淋巴细胞比值（NLR）与真性红细胞增多症（PV）和原发性血小板增多症（ET）的侵袭性相关，并将血栓形成与SC风险联系起来。这表明可能存在共同炎症通路，可能同时影响心血管疾病和癌症的发生。值得注意的是，这种现象在年轻患者中更为常见，可能源于长期暴露于MPN及环境炎症诱因。这些数据强调需要开展新的研究以验证这些关联、厘清事件发生顺序、并寻找治疗靶点，从而减轻血栓事件并可能改善MPN患者的总体预后。

原文链接：

Thrombosis in myeloproliferative neoplasms: a viewpoint on its impact on myelofibrosis, mortality, and solid tumors