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Primary and Secondary Antithrombotic Prophylaxis

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Book cover Myeloproliferative Neoplasms

Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

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Abstract

Patients with polycythemia vera (PV) and essential thrombocythemia (ET) have a thrombotic tendency which may severely impact on their morbidity and mortality.

The prevention of vascular events is the main objective of the whole treatment strategy and relies, in the majority of patients, on cytoreduction and aspirin. The best cytoreductive option for each patient is chosen by balancing vascular and neoplastic risk. Aspirin use has become common in all PV and ET subjects having no contraindication to this drug, although the benefit to risk ratio of aspirin in low-risk ET population remains to be tested. Also the long-term safety of many cytoreductive agents is uncertain, and this makes their use controversial, particularly in patients with intermediate vascular risk. Unfortunately, also risk evaluation in the individual patient is still empirical due to incomplete knowledge of the role of classical risk factors and to the uncertain significance of some disease-related parameters such as platelet and leukocyte abnormalities, inflammation markers and JAK2 status. Given these uncertainties, a rational approach to antithrombotic prophylaxis in PV and ET has to integrate available knowledge with information coming from studies performed in other clinical settings.

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Authors and Affiliations

  1. Haemostasis Research Center, Catholic University School of Medicine, Institute of Internal Medicine and Geriatrics, Rome, Italy

    Leonardo Di Gennaro & Raffaele Landolfi

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  1. Leonardo Di Gennaro
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  2. Raffaele Landolfi
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Correspondence to Raffaele Landolfi .

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Editors and Affiliations

  1. Div. Ematologia, Ospedali Riuniti di Bergamo, Largo Barozzi 1, Bergamo, 24128, Italy

    Tiziano Barbui

  2. Dept. Internal Medicine, Div. Hematology, Mayo Clinic, First Street SW. 200, Rochester, 55905, Minnesota, USA

    Ayalew Tefferi

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Di Gennaro, L., Landolfi, R. (2012). Primary and Secondary Antithrombotic Prophylaxis. In: Barbui, T., Tefferi, A. (eds) Myeloproliferative Neoplasms. Hematologic Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-24989-1_10

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