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Mechanisms of Thrombogenesis

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Book cover Myeloproliferative Neoplasms

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

Abstract

Thrombosis is a leading cause of morbidity and mortality in patients with polycythemia vera (PV) and essential thrombocythemia (ET). A number of mechanisms have been proposed to play a role in the pathogenesis of the acquired thrombophilic state in these diseases, including red blood cell, platelet, and leukocyte abnormalities. Published data demonstrate that neutrophil activation occurs in ET and PV patients in parallel with the appearance of laboratory signs of hemostatic system activation, suggesting an involvement of these cells in the pathogenesis of the thrombotic predisposition of these subjects. Recently, an increase in plasma procoagulant microparticles and the occurrence of an acquired activated protein C resistance have been identified as other two possible mechanisms of systemic hypercoagulability. The acquired point mutation in the pseudokinase domain of Janus kinase 2 (JAK2V617F) in these disorders is under evaluation as a risk factor for thrombosis. JAK2V617F is variably associated with thrombosis and, more consistently, with elevations in blood cell counts. A clear link appears to exist between leukocytosis, JAK2V617F, and the hemostatic system abnormalities underlying the activation of blood coagulation in patients with Bcl-negative myeloproliferative neoplasms.

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Authors and Affiliations

  1. Division of Immunohematology and Transfusion Medicine, Ospedali Riuniti di Bergamo, Bergamo, Italy

    Anna Falanga, Laura Russo & Marina Marchetti

Authors
  1. Anna Falanga
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  2. Laura Russo
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  3. Marina Marchetti
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Correspondence to Anna Falanga .

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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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Falanga, A., Russo, L., Marchetti, M. (2012). Mechanisms of Thrombogenesis. In: Barbui, T., Tefferi, A. (eds) Myeloproliferative Neoplasms. Hematologic Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-24989-1_6

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  • DOI: https://doi.org/10.1007/978-3-642-24989-1_6

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