학술논문
Distinct clinico-molecular arterial and venous thrombosis scores for myeloproliferative neoplasms risk stratification.
Document Type
Academic Journal
Author
Pasquer H; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; INSERM UMR 944, Institut de Recherche Saint-Louis, Paris, France.; Daltro de Oliveira R; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; Vasseur L; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; Soret-Dulphy J; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; Maslah N; Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France.; INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France.; Zhao LP; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; Marcault C; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; Cazaux M; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; Gauthier N; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; Verger E; Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France.; INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France.; Parquet N; Université Paris Cité, APHP, Hôpital Saint-Louis, Département d'hématologie et d'Immunologie, Paris, France.; Vainchenker W; APHP, Hôpital Saint-Louis, Département d'hématologie et d'Immunologie, Paris, France.; Raffoux E; Université Paris Cité, APHP, Hôpital Saint-Louis, Département d'hématologie et d'Immunologie, Paris, France.; Ugo V; Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France.; Luque Paz D; Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France.; Roy L; Université Paris Est Créteil, APHP, Hôpital Henri Mondor, Service d'hématologie, Créteil, France.; Lambert WC; Université de Bretagne Occidentale, CHU de Brest, Service d'Hématologie Biologique, Brest, France.; Ianotto JC; Université de Bretagne Occidentale, CHU de Brest, Service d'Hématologie et d'Hémostase Clinique, Brest, France.; Lippert E; Université de Bretagne Occidentale, CHU de Brest, Service d'Hématologie Biologique, Brest, France.; Giraudier S; Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France.; INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France.; Cassinat B; Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France.; INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France.; Kiladjian JJ; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France.; INSERM UMR 1131, Institut de Recherche Saint-Louis, Paris, France.; Benajiba L; Université Paris Cité, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM CIC 1427, Paris, France. lina.benajiba@aphp.fr.; INSERM UMR 944, Institut de Recherche Saint-Louis, Paris, France. lina.benajiba@aphp.fr.
Source
Publisher: Nature Publishing Group, Specialist Journals Country of Publication: England NLM ID: 8704895 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5551 (Electronic) Linking ISSN: 08876924 NLM ISO Abbreviation: Leukemia Subsets: MEDLINE
Subject
Language
English
Abstract
Current recommended risk scores to predict thrombotic events associated with myeloproliferative neoplasms (MPN) do not discriminate between arterial and venous thrombosis despite their different physiopathology. To define novel stratification systems, we delineated a comprehensive landscape of MPN associated thrombosis across a large long-term follow-up MPN cohort. Prior arterial thrombosis, age >60 years, cardiovascular risk factors and presence of TET2 or DNMT3A mutations were independently associated with arterial thrombosis in multivariable analysis. ARTS, an ARterial Thrombosis Score, based on these four factors, defined low- (0.37% patients-year) and high-risk (1.19% patients-year) patients. ARTS performance was superior to the two-tiered conventional risk stratification in our training cohort, across all MPN subtypes, as well as in two external validation cohorts. Prior venous thrombosis and presence of a JAK2 V617F mutation with a variant allelic frequency ≥50% were independently associated with venous thrombosis. The discrimination potential of VETS, a VEnous Thrombosis Score based on these two factors, was poor, similar to the two-tiered conventional risk stratification. Our study pinpoints arterial and venous thrombosis clinico-molecular differences and proposes an arterial risk score for more accurate patients' stratification. Further improvement of venous risk scores, accounting for additional factors and considering venous thrombosis as a heterogeneous entity is warranted.
(© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)
(© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)