Myeloproliferative neoplasms and splanchnic vein thrombosis: Contemporary diagnostic and therapeutic strategies.
Review published in American journal of hematology (2023)
Abstract
Myeloproliferative neoplasms (MPNs) are the most common etiologies of primary splanchnic vein thrombosis, present in almost forty percent of patients with Budd-Chiari syndrome or portal vein thrombosis. Diagnosis of MPNs can be difficult in these patients because key characteristics, such as elevated blood cell counts and splenomegaly, are confounded by portal hypertension or bleeding complications. In recent years, diagnostic tools have improved to provide more accurate diagnosis and classification of MPNs. Although bone marrow biopsy findings remain a major diagnostic criterion, molecular markers are playing an increasing role not only in diagnosis but also in better estimating prognosis. Therefore, though screening for JAK2V617F mutation should be the starting point of the diagnostic workup performed in all patients with splanchnic vein thrombosis, a multidisciplinary approach is needed to accurately diagnose the subtype of myeloproliferative neoplasm, recommend the useful additional tests (bone marrow biopsy, search for an additional mutation using targeted next-generation sequencing), and suggest the best treatment strategy. Indeed, providing a specific expert care pathway for patients with splanchnic vein thrombosis and underlying myeloproliferative neoplasm is crucial to determine the optimal management to reduce the risk of both hematological and hepatic complications.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Myeloproliferative neoplasms (MPNs) are the most common etiologies of primary splanchnic vein thrombosis, present in almost forty percent of patients with Budd-Chiari syndrome or portal vein thrombosis. Diagnosis of MPNs can be difficult in these patients because key characteristics, such as elevated blood cell counts and splenomegaly, are confounded by portal hypertension or bleeding complications.
Why This Matters for Hirudotherapy
This review addresses the diagnosis and management of myeloproliferative neoplasms (MPNs), which underlie almost forty percent of primary splanchnic vein thromboses such as Budd-Chiari syndrome and portal vein thrombosis, emphasizing JAK2V617F mutation screening, bone marrow biopsy, next-generation sequencing, and a multidisciplinary care pathway to reduce hematologic and hepatic complications. Its relevance to ASH is indirect, sitting in the broader thrombosis literature that motivates antithrombotic research: it illustrates a hypercoagulable disease state where managing clotting risk is central, the clinical territory in which leech-derived anticoagulants and the medicinal-leech secretome are conceptually situated. This is a review of diagnostic and therapeutic strategies rather than primary data, focuses on hematologic disease and conventional management, and does not discuss leech-derived compounds or hirudotherapy; treat it as background on a thrombosis-prone condition, not as evidence for leech therapy.
Citation
Myeloproliferative neoplasms and splanchnic vein thrombosis: Contemporary diagnostic and therapeutic strategies.
Kiladjian et al. · American journal of hematology, 2023
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