{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:56:30Z","timestamp":1792443390669,"version":"4.5.0"},"reference-count":58,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Overt primary myelofibrosis (PMF), secondary post-polycythemia vera (post-PV), and post-essential thrombocythemia (post-ET) myelofibrosis (SMF) are chronic myeloproliferative neoplasms (MPN) that sometimes present with extreme thrombocytosis (ExTh, platelet count &gt; 1000 \u00d7 109\/L), a phenomenon of uncertain clinical significance since there are no published data available. Methods: We retrospectively investigated the clinical correlations and associated outcomes of ExTh in a cohort of 172 patients with overt myelofibrosis diagnosed in six Croatian hematology centers. Results: ExTh was present in 5.8% of patients and was associated with post-ET etiology of myelofibrosis, older age, smaller spleen size, and the presence of arterial hypertension (p &lt; 0.05 for all analyses). No significant associations were observed with sex, degree of bone marrow fibrosis, or driver mutation status. Over the follow-up period, patients with ExTh experienced a favorable course regarding survival (p &lt; 0.001) and bleeding risk (p = 0.034), whereas no significant association with thrombotic risk was observed (p = 0.682). Conclusions: In contrast to its context in ET, ExTh in overt fibrotic MPN does not appear to confer higher bleeding or thrombotic risk. Instead, it is associated with more favorable survival outcomes and reduced bleeding risk.<\/jats:p>","DOI":"10.3390\/cancers17091390","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T20:11:48Z","timestamp":1745352708000},"page":"1390","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Extreme Thrombocytosis in Patients with Overt Myelofibrosis and Its Clinical Associations"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1372-2040","authenticated-orcid":false,"given":"Marko","family":"Lucijanic","sequence":"first","affiliation":[{"name":"Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia"},{"name":"Scientific Research and Translational Medicine Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, Ul. Salata 3, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8642-305X","authenticated-orcid":false,"given":"Ivan","family":"Krecak","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, General Hospital Sibenik, Ul. Stjepana Radica 83, 22000 Sibenik, Croatia"},{"name":"School of Medicine, University of Rijeka, Ul. Brace Branchetta 20\/1, 51000 Rijeka, Croatia"},{"name":"Sibenik University of Applied Science, Trg Andrije Hebranga 11, 22000 Sibenik, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ena","family":"Soric","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anica","family":"Sabljic","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davor","family":"Galusic","sequence":"additional","affiliation":[{"name":"Department of Hematology, University Hospital of Split, Soltanska ul. 1, 21000 Split, Croatia"},{"name":"School of Medicine, University of Split, Soltanska ul. 2, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hrvoje","family":"Holik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cDr. Josip Bencevic\u201d General Hospital, Ul. Andrije Stampara, 35000 Slavonski Brod, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-1270","authenticated-orcid":false,"given":"Vlatka","family":"Perisa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000 Osijek, Croatia"},{"name":"Department of Hematology, Osijek University Hospital, Ul. Josipa Huttlera 4, 31000 Osijek, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Moric Peric","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000 Zadar, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Zekanovic","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000 Zadar, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Budimir","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, Ul. Salata 3, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajko","family":"Kusec","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41408-018-0054-y","article-title":"The 2016 who classification and diagnostic criteria for myeloproliferative neoplasms: Document summary and in-depth discussion","volume":"8","author":"Barbui","year":"2018","journal-title":"Blood Cancer J."},{"key":"ref_2","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","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1182\/hematology.2024000576","article-title":"Molecular profiling in mpn: Who should have it and why?","volume":"2024","author":"Chee","year":"2024","journal-title":"Hematol. 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