The Role of Direct Oral Anticoagulants in Managing Myeloproliferative Neoplasms Patients.

IF 4.1 2区医学 Q2 ONCOLOGY

Cancer Research and Treatment Pub Date : 2024-09-20 DOI:10.4143/crt.2024.738

Ji Yun Lee, Ju-Hyun Lee, Woochan Park, Jeongmin Seo, Minsu Kang, Eun Hee Jung, Sang-A Kim, Koung Jin Suh, Ji-Won Kim, Se Hyun Kim, Jeong-Ok Lee, Jin Won Kim, Yu Jung Kim, Keun-Wook Lee, Jee Hyun Kim, Soo-Mee Bang

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引用次数: 0

Abstract

Purpose: Thrombosis and bleeding significantly affect morbidity and mortality in myeloproliferative neoplasms (MPNs). The efficacy and safety of direct oral anticoagulants (DOACs) in MPN patients remain uncertain.

Materials and methods: We conducted a large, retrospective, nationwide cohort study using the Korean Health Insurance Review and Assessment Service database from 2010 to 2021.

Results: Out of the 368 MPN patients included in the final analysis, 62.8% were treated with DOACs for atrial fibrillation (AF), and 37.2% for venous thromboembolism (VTE). The AF group was statistically older with higher CHA2DS2-VASc scores compared to the VTE group. Antiplatelet agents were used in 51.1% of cases, and cytoreductive drugs in 79.3%, with hydroxyurea being the most common (64.9%). The median follow-up was 22.3 months, with one-year cumulative incidence rates of thrombosis and bleeding at 11.1% and 3.7%, respectively. Multivariate analysis identified CHA2DS2-VASc scores ≥ 3 (HR=3.48), concomitant antiplatelet use (HR = 2.57), and cytoreduction (HR=2.20) as significant thrombosis risk factors but found no significant predictors for major bleeding.

Conclusion: Despite the limitations of retrospective data, DOAC treatment in MPN patients seems effective and has an acceptable bleeding risk.

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直接口服抗凝剂在治疗骨髓增生性肿瘤患者中的作用。

目的：血栓形成和出血严重影响骨髓增生性肿瘤（MPN）的发病率和死亡率。直接口服抗凝药（DOACs）对骨髓增生性肿瘤患者的疗效和安全性仍不确定：我们利用韩国健康保险审查和评估服务数据库开展了一项大型、回顾性、全国性队列研究（2010-2021 年）：在纳入最终分析的 368 名 MPN 患者中，62.8% 因心房颤动（AF）而接受 DOACs 治疗，37.2% 因静脉血栓栓塞（VTE）而接受 DOACs 治疗。据统计，与 VTE 组相比，房颤组患者的年龄更大，CHA2DS2-VASc 评分更高。51.1%的病例使用了抗血小板药物，79.3%的病例使用了细胞修复药物，其中羟基脲最为常见（64.9%）。中位随访时间为22.3个月，血栓和出血的一年累计发生率分别为11.1%和3.7%。多变量分析发现，CHA2DS2-VASc评分≥3（HR=3.48）、同时使用抗血小板药物（HR=2.57）和细胞减灭术（HR=2.20）是血栓形成的重要风险因素，但未发现大出血的重要预测因素：尽管回顾性数据存在局限性，但对骨髓增生性疾病患者进行 DOAC 治疗似乎是有效的，而且出血风险可以接受。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Research and Treatment ONCOLOGY-

CiteScore

8.00

自引率

2.20%

发文量

126

审稿时长

>12 weeks

期刊介绍： Cancer Research and Treatment is a peer-reviewed open access publication of the Korean Cancer Association. It is published quarterly, one volume per year. Abbreviated title is Cancer Res Treat. It accepts manuscripts relevant to experimental and clinical cancer research. Subjects include carcinogenesis, tumor biology, molecular oncology, cancer genetics, tumor immunology, epidemiology, predictive markers and cancer prevention, pathology, cancer diagnosis, screening and therapies including chemotherapy, surgery, radiation therapy, immunotherapy, gene therapy, multimodality treatment and palliative care.