Benefice and pitfall of direct oral anticoagulants in very high-risk myeloproliferative neoplasms - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue (Article De Synthèse) Thrombosis Research Année : 2022

Benefice and pitfall of direct oral anticoagulants in very high-risk myeloproliferative neoplasms

Laura Herbreteau
  • Fonction : Auteur
Lenaïg Le Clech
  • Fonction : Auteur
Geoffrey Garcia
  • Fonction : Auteur
Chloé James
  • Fonction : Auteur
Brigitte Pan-Petesch
  • Fonction : Auteur
Francis Couturaud
  • Fonction : Auteur
Eric Lippert
Jean-Christophe Ianotto
  • Fonction : Auteur

Résumé

Thrombotic and hemorrhagic complications are related to a significant rate of morbidity and mortality in patients with myeloproliferative neoplasms (MPNs), they are therefore called “thrombohemorrhagic” syndromes. Several clinical factors, such as age and presence of cardiovascular comorbidities are responsible for thrombotic complications. High blood counts, platelet alterations, presence of JAK2 mutation and possibly of other CHIP mutations such as TET2, DNMT3A, and ASXL1, procoagulant microparticles, NETs formation, endothelial activation and neo-angiogenesis are some of the parameters accounting for hypercoagulability in patients with myeloproliferative neoplasms. Bleeding complications emerge as a result of platelet exhaustion. They can be also linked to a functional deficiency of von Willebrand factor, when platelet counts rise above 1000G/L. The mainstay of management consists on preventing hemostatic complications, by antiplatelet and/or anticoagulant treatment and myelosuppressive agents in high-risk patients.Circumstances related to a high thrombohemorrhagic risk, such as pregnancy and the perioperative period, prompt for specific management with regards to anticoagulation and myelosuppression treatment type. In order to apply a patient-specific treatment strategy, there is a need for a risk score assessment tool encompassing clinical parameters and hemostasis biomarkers.
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Dates et versions

hal-03992708 , version 1 (16-02-2023)

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Citer

Laura Herbreteau, Loula Papageorgiou, Lenaïg Le Clech, Geoffrey Garcia, Chloé James, et al.. Benefice and pitfall of direct oral anticoagulants in very high-risk myeloproliferative neoplasms. Thrombosis Research, 2022, 216, pp.25-34. ⟨10.1016/j.thromres.2022.05.015⟩. ⟨hal-03992708⟩
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