Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study
Abstract: Bleeding and thrombotic events are known complications in myeloproliferative neoplasms (MPNs), but few studies have exclusively focused on patients with myelofibrosis (MF). In this nationwide population-based study, we assessed the frequency of major bleeding, thrombotic events, and all-ca...
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Elsevier
2025-06-01
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| Series: | Blood Advances |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2473952925001831 |
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| author | Anneli Enblom Larsson Henrik Renlund Björn Andréasson Henrik Holmberg Maria Liljeholm Anders Själander |
| author_facet | Anneli Enblom Larsson Henrik Renlund Björn Andréasson Henrik Holmberg Maria Liljeholm Anders Själander |
| author_sort | Anneli Enblom Larsson |
| collection | DOAJ |
| description | Abstract: Bleeding and thrombotic events are known complications in myeloproliferative neoplasms (MPNs), but few studies have exclusively focused on patients with myelofibrosis (MF). In this nationwide population-based study, we assessed the frequency of major bleeding, thrombotic events, and all-cause mortality in 1079 patients diagnosed with MF and 5395 matched controls using multiple Swedish health care registers. Major bleeding, arterial, and venous events were seen at a rate of 2.55, 2.59, and 1.06 events per 100 years, respectively, in patients with MF. Compared to controls, the rates of bleedings, arterial events, venous events, and mortality were increased, with hazard ratios of 3.78 (95% confidence interval [CI], 2.98-4.79; P < .001), 1.73 (95% CI, 1.40-2.12; P < .001), 2.75 (95% CI, 1.93-3.90; P < .001), and 3.92 (95% CI, 3.50-4.40; P < .001), respectively. Patients treated with JAK inhibitors (JAKis) had higher rates of major bleeding (5.33), arterial events (4.67), and venous events (1.56) than patients with no ongoing symptom–directed therapy (rates, 2.32, 2.15, and 0.79) or hydroxyurea (rates, 2.05, 2.35, and 1.27, respectively). The use of JAKis or low-molecular-weight heparin, previous arterial or venous events, and older age were identified as independent risk factors for new arterial or venous events. A previous venous event, higher leukocyte count at diagnosis, and ongoing JAKi treatment were associated with an increased risk of major bleeding. This study shows that patients with MF have higher rates of thromboembolic events and major bleeding than described in other MPNs, and thromboembolic complications and major bleeding diverge in the different treatment groups. |
| format | Article |
| id | doaj-art-97dc6ae4c8b740a79ee51ad39c09338b |
| institution | OA Journals |
| issn | 2473-9529 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | Blood Advances |
| spelling | doaj-art-97dc6ae4c8b740a79ee51ad39c09338b2025-08-20T02:02:25ZengElsevierBlood Advances2473-95292025-06-019112783279310.1182/bloodadvances.2025016247Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based studyAnneli Enblom Larsson0Henrik Renlund1Björn Andréasson2Henrik Holmberg3Maria Liljeholm4Anders Själander5Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Correspondence: Anneli Enblom Larsson, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden;Uppsala Clinical Research Center, Uppsala University, Uppsala, SwedenDepartment of Hematology, NU Hospital Group, Uddevalla, SwedenDepartment of Epidemiology and Global Health, Umeå University, Umeå, SwedenDepartment of Diagnostics and Intervention, Oncology, Umeå University, Umeå, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, SwedenAbstract: Bleeding and thrombotic events are known complications in myeloproliferative neoplasms (MPNs), but few studies have exclusively focused on patients with myelofibrosis (MF). In this nationwide population-based study, we assessed the frequency of major bleeding, thrombotic events, and all-cause mortality in 1079 patients diagnosed with MF and 5395 matched controls using multiple Swedish health care registers. Major bleeding, arterial, and venous events were seen at a rate of 2.55, 2.59, and 1.06 events per 100 years, respectively, in patients with MF. Compared to controls, the rates of bleedings, arterial events, venous events, and mortality were increased, with hazard ratios of 3.78 (95% confidence interval [CI], 2.98-4.79; P < .001), 1.73 (95% CI, 1.40-2.12; P < .001), 2.75 (95% CI, 1.93-3.90; P < .001), and 3.92 (95% CI, 3.50-4.40; P < .001), respectively. Patients treated with JAK inhibitors (JAKis) had higher rates of major bleeding (5.33), arterial events (4.67), and venous events (1.56) than patients with no ongoing symptom–directed therapy (rates, 2.32, 2.15, and 0.79) or hydroxyurea (rates, 2.05, 2.35, and 1.27, respectively). The use of JAKis or low-molecular-weight heparin, previous arterial or venous events, and older age were identified as independent risk factors for new arterial or venous events. A previous venous event, higher leukocyte count at diagnosis, and ongoing JAKi treatment were associated with an increased risk of major bleeding. This study shows that patients with MF have higher rates of thromboembolic events and major bleeding than described in other MPNs, and thromboembolic complications and major bleeding diverge in the different treatment groups.http://www.sciencedirect.com/science/article/pii/S2473952925001831 |
| spellingShingle | Anneli Enblom Larsson Henrik Renlund Björn Andréasson Henrik Holmberg Maria Liljeholm Anders Själander Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study Blood Advances |
| title | Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study |
| title_full | Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study |
| title_fullStr | Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study |
| title_full_unstemmed | Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study |
| title_short | Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study |
| title_sort | thrombosis major bleeding and mortality in 1079 patients with myelofibrosis a matched population based study |
| url | http://www.sciencedirect.com/science/article/pii/S2473952925001831 |
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