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Antiplatelet, Anticoagulation Therapies Significantly Increase Bleeding Risk for MPNs
A retrospective study found antiplatelet and anticoagulation therapies significantly increase the risk of bleeding in patients with myeloproliferative neoplasms (MPNs) without affecting mortality (Eur J Haematol. 2022 Feb;108(2):154-162. Epub ahead of print).
“In patients with bcr-abl-negative MPNs, concerns are often raised about the use of anticoagulants because of an increased bleeding risk. However, there are few MPN studies focusing on bleeding,” said Kai Wille, MD, University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, Johannes Wesling Medical Center Minden, University of Bochum, Minden, Germany, and co-authors.
Thus, Dr Wille and co-authors reported the results of a single-center study on bleeding complications in 829 patients with MPNs with a median follow-up of 5.5 years (range 0.1-35.6).
Out of all (n=829) patients, 143 (17.2%) experienced a bleeding event, resulting in an incidence rate of 2.29% per patient/year. During the follow-up period, 1 patient died due to bleeding.
Most bleeding events happened in patients on antiplatelet therapies (60.1%), followed by patients on anticoagulation therapies (20.3%), and patients not on anticoagulation therapies (19.6%).
In a multivariate analysis, administering antiplatelet (HR 2.31 [1.43, 3.71]) and anticoagulation therapies (HR 4.06 [2.32, 7.09]), but not age, gender, or mutation status, was associated with an increase in the risk of bleeding.
When researchers compared the probability of bleeding-free survival between MPN subtypes, no significant differences were identified (P = 0.91; log-rank test).
“Our retrospective study shows that antiplatelet and anticoagulation therapies significantly increase the risk of bleeding in MPN patients without affecting mortality. However, there is no reason to refrain from guideline-conform primary or secondary anticoagulation in MPN patients,” concluded Dr Wille et al.—Emily Bader
