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Annals of Hematology

, Volume 93, Issue 12, pp 1953–1963 | Cite as

Prophylaxis and management of venous thromboembolism in patients with myeloproliferative neoplasms: consensus statement of the Haemostasis Working Party of the German Society of Hematology and Oncology (DGHO), the Austrian Society of Hematology and Oncology (ÖGHO) and Society of Thrombosis and Haemostasis Research (GTH e.V.)

  • Stephan Kreher
  • Sebastian Ochsenreither
  • Ralf U. Trappe
  • Ingrid Pabinger
  • Frauke Bergmann
  • Petro E. Petrides
  • Steffen Koschmieder
  • Axel Matzdorff
  • Andreas Tiede
  • Martin Griesshammer
  • Hanno Riess
Review Article

Abstract

Patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) like polycythemia vera and essential thrombocythemia are at increased risk of arterial and venous thrombosis. Strategies of prevention may consist of platelet aggregation inhibitors and/or cytoreductive agents depending on the underlying disease and the individual risk. Clinical evidence for management of acute venous thromboembolic events in MPN patients is limited. Modality and duration of therapeutic anticoagulation after venous thrombosis has to be evaluated critically with special regard to the increased risk for spontaneous bleeding events associated with the underlying diseases. Both for therapy of the acute event and for secondary prophylaxis, low-molecular-weight heparins should preferentially be used. A prolongation of the therapeutic anticoagulation beyond the usual 3 to 6 months can only be recommended in high-risk settings and after careful evaluation of potential risks and benefits for the individual patient. New direct oral anticoagulants (NOAC) should not preferentially be used due to lack of clinical experience in patients with MPN and potential drug interactions (e.g. with JAK inhibitors). Consequent treatment of the underlying myeloproliferative disease and periodical evaluation of the response to therapy is crucial for optimal secondary prophylaxis of thromboembolic events in those patients.

Keywords

Venous thromboembolism Myeloproliferative neoplasm Essential thrombocythemia Polycythemia vera 

Notes

Authorship and disclosures

All authors contributed and approved the report.

Conflict of interest

The authors report no potential conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Stephan Kreher
    • 1
  • Sebastian Ochsenreither
    • 1
  • Ralf U. Trappe
    • 2
  • Ingrid Pabinger
    • 3
  • Frauke Bergmann
    • 4
  • Petro E. Petrides
    • 5
  • Steffen Koschmieder
    • 6
  • Axel Matzdorff
    • 7
  • Andreas Tiede
    • 8
  • Martin Griesshammer
    • 9
  • Hanno Riess
    • 1
  1. 1.Department of Hematology and OncologyCharite BerlinBerlinGermany
  2. 2.Department of Hematology and Oncology, DIAKOEv. Diakonie-Krankenhaus GmbHBremenGermany
  3. 3.Clinical Department for Hematology and HemostaseologyVienna General Hospital–University ClinicViennaAustria
  4. 4.MVZ Wagnerstibbe Für Laboratoriumsmedizin Und Pathologie GmbHHannoverGermany
  5. 5.Hematology Oncology CenterMunich IsartorMunichGermany
  6. 6.Department of Hematology, Oncology and Stem Cell TransplantationUniversity Hospital RWTH AachenAachenGermany
  7. 7.Department of Hematology and OncologyCaritas Klinikum SaarbrückenSaarbrückenGermany
  8. 8.Department for Hematology, Hemostaseology, Oncology and Stem Cell TransplantationHannover Medical SchoolHannoverGermany
  9. 9.Department of Hematology, Oncology and Palliative CareMühlenkreiskliniken Johannes Wesling Klinikum MindenMindenGermany

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