Arterial thrombosis in Philadelphia-negative myeloproliferative neoplasms predicts second cancer: A case-control study

V. De Stefano, A. Ghirardi, A. Masciulli, A. Carobbio, F. Palandri, N. Vianelli, E. Rossi, S. Betti, A. Di Veroli, A. Iurlo, D. Cattaneo, G. Finazzi, M. Bonifacio, L. Scaffidi, A. Patriarca, E. Rumi, I.C. Casetti, C. Stephenson, P. Guglielmelli, E.M. ElliM. Palova, D. Rapezzi, D. Erez, M. Gomez, K. Wille, M. Perez-Encinas, F. Lunghi, A. Angona, M.L. Fox, E. Beggiato, G. Benevolo, G. Carli, R. Cacciola, M.F. McMullin, A. Tieghi, V. Recasens, S. Isfort, M. Marchetti, M. Griesshammer, A. Alvarez-Larran, A.M. Vannucchi, A. Rambaldi, T. Barbui

Research output: Contribution to journalArticlepeer-review


Patients with Philadelphia-negative myeloproliferative neoplasm (MPN) are prone to the development of second cancers, but the factors associated with these events have been poorly explored. In an international nested case-control study, we recruited 647 patients with carcinoma, nonmelanoma skin cancer, hematological second cancer, and melanoma diagnosed concurrently or after MPN diagnosis. Up to 3 control patients without a history of cancer and matched with each case for center, sex, age at MPN diagnosis, date of diagnosis, and MPN disease duration were included (n 5 1234). Cases were comparable to controls for MPN type, driver mutations and cardiovascular risk factors. The frequency of thrombosis preceding MPN was similar for cases and controls (P 5 .462). Thrombotic events after MPN and before second cancer were higher in cases than in controls (11.6% vs 8.1%; P 5 .013), because of a higher proportion of arterial thromboses (6.2% vs 3.7%; P 5 .015). After adjustment for confounders, the occurrence of arterial thrombosis remained independently associated with the risk of carcinoma (odds ratio, 1.97; 95% confidence interval, 1.14-3.41), suggesting that MPN patients experiencing arterial events after MPN diagnosis deserve careful clinical surveillance for early detection of carcinoma.

Original languageEnglish
Pages (from-to)381-386
Number of pages6
Issue number5
Publication statusPublished - 2020


  • acetylsalicylic acid
  • hydroxyurea
  • acute heart infarction
  • adult
  • artery thrombosis
  • Article
  • brain ischemia
  • carcinoma
  • cardiovascular risk
  • case control study
  • controlled clinical trial
  • controlled study
  • deep vein thrombosis
  • disease association
  • disease duration
  • follow up
  • gene mutation
  • hematologic malignancy
  • human
  • low drug dose
  • lung embolism
  • major clinical study
  • myeloproliferative neoplasm
  • non melanoma skin cancer
  • Philadelphia chromosome negative cell
  • priority journal
  • second cancer
  • thrombosis
  • transient ischemic attack
  • unstable angina pectoris
  • vein thrombosis


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