Addressing and proposing solutions for unmet clinical needs in the management of myeloproliferative neoplasm-associated thrombosis

A consensus-based position paper

Tiziano Barbui, Valerio De Stefano, Anna Falanga, Guido Finazzi, Ida Martinelli, Francesco Rodeghiero, Alessandro M. Vannucchi, Giovanni Barosi

Research output: Contribution to journalArticle

Abstract

This article presents the results of a group discussion among an ad hoc constituted Panel of experts aimed at highlighting unmet clinical needs (UCNs) in the management of thrombotic risk and thrombotic events associated with Philadelphia-negative myeloproliferative neoplasms (Ph-neg MPNs). With the Delphi technique, the challenges in Ph-neg MPN-associated thrombosis were selected. The most clinically relevant UCNs resulted in: (1) providing evidence of the benefits and risks of direct oral anticoagulants, (2) providing evidence of the benefits and risks of cytoreduction in patients with splanchnic vein thrombosis without hypercythemia, (3) improving knowledge of the role of the mutated endothelium in the pathogenesis of thrombosis, (4) improving aspirin dosing regimens in essential thrombocythemia, (5) improving antithrombotic management of Ph-neg MPN-associated pregnancy, (6) providing evidence for the optimal duration of anticoagulation for prophylaxis of recurrent VTE, (7) improving knowledge of the association between somatic gene mutations and risk factors for thrombosis, and (8) improving the grading system of thrombosis risk in polycythemia vera. For each of these issues, proposals for advancement in research and clinical practice were addressed. Hopefully, this comprehensive overview will serve to inform the design and implementation of new studies in the field.

Original languageEnglish
Article number61
JournalBlood Cancer Journal
Volume9
Issue number8
DOIs
Publication statusPublished - Aug 1 2019

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Thrombosis
Neoplasms
Delphi Technique
Essential Thrombocythemia
Polycythemia Vera
Viscera
Risk Management
Anticoagulants
Aspirin
Endothelium
Veins
Pregnancy
Mutation
Research
Genes

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Addressing and proposing solutions for unmet clinical needs in the management of myeloproliferative neoplasm-associated thrombosis : A consensus-based position paper. / Barbui, Tiziano; De Stefano, Valerio; Falanga, Anna; Finazzi, Guido; Martinelli, Ida; Rodeghiero, Francesco; Vannucchi, Alessandro M.; Barosi, Giovanni.

In: Blood Cancer Journal, Vol. 9, No. 8, 61, 01.08.2019.

Research output: Contribution to journalArticle

Barbui, Tiziano ; De Stefano, Valerio ; Falanga, Anna ; Finazzi, Guido ; Martinelli, Ida ; Rodeghiero, Francesco ; Vannucchi, Alessandro M. ; Barosi, Giovanni. / Addressing and proposing solutions for unmet clinical needs in the management of myeloproliferative neoplasm-associated thrombosis : A consensus-based position paper. In: Blood Cancer Journal. 2019 ; Vol. 9, No. 8.
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