{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:50:00Z","timestamp":1790419800075,"version":"4.1.0"},"reference-count":37,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Patients with myeloproliferative neoplasms (MPNs), polycythemia vera, essential thrombocythemia, and primary myelofibrosis, have an increased risk of thrombosis. Risk of recurrent thrombosis can be reduced with antithrombotic therapy and\/or cytoreduction, but the optimal long-term management in patients with MPN with a history of venous thromboembolism (VTE) is unknown, and clinical practice is heterogeneous. We performed a systematic review and meta-analysis of randomized trials and observational studies evaluating anticoagulant and\/or antiplatelet therapy, with or without cytoreduction, in MPN patients with a history of VTE. A total of 5675 unique citations were screened for eligibility. No randomized trials were identified. Ten observational studies involving 1295 patients with MPN were included in the analysis. Overall, 23% had an arterial or recurrent venous thrombotic event on follow-up. The recurrence risk was lowest for patients on oral anticoagulation plus cytoreduction (16%); 55 of 313 (18%) with vitamin K antagonists (VKA) and 5 of 63 (8%) with direct oral anticoagulants (DOACs). In 746 analyzed patients, the risk of recurrent VTE ranged up to 33% (median 13%) and was low in 63 DOAC plus cytoreduction-treated patients (3.2%). All types of antithrombotic treatments were associated with a lower risk of recurrent VTE when combined with cytoreduction. Most studies had a high risk of bias, whereas clinical and statistical heterogeneity led to inconsistent and imprecise findings. In summary, evidence on the optimal antithrombotic treatment of VTE in patients with MPN is based on observational studies only with low certainty for all strategies. Our data suggest that a combination of anticoagulation and cytoreduction may provide the lowest recurrence risk.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020003628","type":"journal-article","created":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T04:14:10Z","timestamp":1610079250000},"page":"113-121","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":63,"title":["A systematic review of antithrombotic treatment of venous thromboembolism in patients with myeloproliferative neoplasms"],"prefix":"10.1182","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9340-8771","authenticated-orcid":false,"given":"Eva N.","family":"Hamuly\u00e1k","sequence":"first","affiliation":[{"name":"Department of Vascular Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8025-4961","authenticated-orcid":false,"given":"Joost G.","family":"Daams","sequence":"additional","affiliation":[{"name":"Medical Library, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5677-1371","authenticated-orcid":false,"given":"Frank W. G.","family":"Leebeek","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus University Medical Center (Erasmus MC) Rotterdam, Rotterdam, The Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4426-5743","authenticated-orcid":false,"given":"Bart J.","family":"Biemond","sequence":"additional","affiliation":[{"name":"Department of Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3566-5016","authenticated-orcid":false,"given":"Peter A. W.","family":"te Boekhorst","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus University Medical Center (Erasmus MC) Rotterdam, Rotterdam, The Netherlands; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1006-6420","authenticated-orcid":false,"given":"Saskia","family":"Middeldorp","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0398-3164","authenticated-orcid":false,"given":"Mandy N.","family":"Lauw","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine and"},{"name":"Department of Hematology, Erasmus University Medical Center (Erasmus MC) Rotterdam, Rotterdam, The Netherlands; and"},{"name":"Department of Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2021,1,5]]},"reference":[{"issue":"20","key":"2021010516362164400_B1","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia [published correction in Blood. 2016;128(3):462-463]","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"issue":"5","key":"2021010516362164400_B2","doi-asserted-by":"crossref","first-page":"317","DOI":"10.7326\/M17-0028","article-title":"Patients with myeloproliferative neoplasms: a population-based cohort study","volume":"168","author":"Hultcrantz","year":"2018","journal-title":"Ann Intern Med"},{"issue":"4","key":"2021010516362164400_B3","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1182\/blood-2009-08-238956","article-title":"Thrombosis in primary myelofibrosis: incidence and risk factors","volume":"115","author":"Barbui","year":"2010","journal-title":"Blood"},{"issue":"22","key":"2021010516362164400_B4","doi-asserted-by":"crossref","first-page":"5857","DOI":"10.1182\/blood-2011-02-339002","article-title":"Risk factors for arterial and venous thrombosis in WHO-defined essential thrombocythemia: an international study of 891 patients","volume":"117","author":"Carobbio","year":"2011","journal-title":"Blood"},{"issue":"19","key":"2021010516362164400_B5","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1182\/blood-2014-07-591610","article-title":"In contemporary patients with polycythemia vera, rates of thrombosis and risk factors delineate a new clinical epidemiology","volume":"124","author":"Barbui","year":"2014","journal-title":"Blood"},{"issue":"25","key":"2021010516362164400_B6","doi-asserted-by":"crossref","first-page":"4921","DOI":"10.1182\/blood-2011-09-376517","article-title":"Myeloproliferative neoplasms in Budd-Chiari syndrome and portal vein thrombosis: a meta-analysis","volume":"120","author":"Smalberg","year":"2012","journal-title":"Blood"},{"issue":"22","key":"2021010516362164400_B7","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1182\/blood.2019001318","article-title":"From Budd-Chiari syndrome to acquired von Willebrand syndrome: thrombosis and bleeding complications in the myeloproliferative neoplasms","volume":"134","author":"Stein","year":"2019","journal-title":"Blood"},{"issue":"11","key":"2021010516362164400_B8","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1182\/bloodadvances.2019000211","article-title":"Leukocytosis and thrombosis in essential thrombocythemia and polycythemia vera: a systematic review and meta-analysis","volume":"3","author":"Carobbio","year":"2019","journal-title":"Blood Adv"},{"issue":"4","key":"2021010516362164400_B9","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/978-3-030-20315-3_11","article-title":"Thrombosis in the philadelphia chromosome-negative myeloproliferative neoplasms","volume":"179","author":"Sankar","year":"2019","journal-title":"Cancer Treat Res"},{"issue":"1","key":"2021010516362164400_B10","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.thromres.2014.03.040","article-title":"Cerebral venous thrombosis and myeloproliferative neoplasms: results from two large databases","volume":"134","author":"Dentali","year":"2014","journal-title":"Thromb Res"},{"issue":"11","key":"2021010516362164400_B11","doi-asserted-by":"crossref","first-page":"E200","DOI":"10.1002\/ajh.23809","article-title":"Cerebral vein thrombosis in patients with Philadelphia-negative myeloproliferative neoplasms. 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