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Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs

SIMPLE SUMMARY: Splanchnic vein thromboses (SVTs) are atypical clots associated with myeloproliferative neoplasms (MPNs). However, there are no well-established guidelines on how to treat them. The aim of this review is to explore treatment considerations of SVT in the setting of MPN (MPN-SVT). Anti...

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Autores principales: Liu, Angela, Naymagon, Leonard, Tremblay, Douglas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817858/
https://www.ncbi.nlm.nih.gov/pubmed/36612008
http://dx.doi.org/10.3390/cancers15010011
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author Liu, Angela
Naymagon, Leonard
Tremblay, Douglas
author_facet Liu, Angela
Naymagon, Leonard
Tremblay, Douglas
author_sort Liu, Angela
collection PubMed
description SIMPLE SUMMARY: Splanchnic vein thromboses (SVTs) are atypical clots associated with myeloproliferative neoplasms (MPNs). However, there are no well-established guidelines on how to treat them. The aim of this review is to explore treatment considerations of SVT in the setting of MPN (MPN-SVT). Anticoagulation is the cornerstone of therapy and cytoreductive therapy is recommended per MPN treatment guidelines. Endovascular intervention may also be considered in patients with occlusive or extensive clot burden in the acute setting to prevent or mitigate potential portal hypertensive complications. Beyond these general approaches, there are still gaps in our knowledge of how to treat MPN-SVT, including the optimal dose and timing of anticoagulation, role of endovascular interventions and novel agents, and management of patients with MPN-SVT without elevated counts. Future studies will be needed to bridge the gap of these unmet needs. ABSTRACT: Patients who develop splanchnic vein thrombosis (SVT) in the setting of a myeloproliferative neoplasm (MPN) are at risk for complications including portal hypertension, bleeding, thrombosis, and death. Prompt multidisciplinary treatment is thus necessary to prevent long-term sequelae. However, optimal management strategies are not well established due to a paucity of data. In this review, we very briefly discuss the epidemiology, pathophysiology, and prognosis of MPN-SVT and then more comprehensively explore treatment considerations of MPN-SVT, including anticoagulation, endovascular/surgical intervention, and cytoreductive therapy. We will also highlight current gaps in our knowledge of MPN-SVT and conclude by suggesting future directions to optimize the treatment of MPN-SVT and improve outcomes.
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spelling pubmed-98178582023-01-07 Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs Liu, Angela Naymagon, Leonard Tremblay, Douglas Cancers (Basel) Review SIMPLE SUMMARY: Splanchnic vein thromboses (SVTs) are atypical clots associated with myeloproliferative neoplasms (MPNs). However, there are no well-established guidelines on how to treat them. The aim of this review is to explore treatment considerations of SVT in the setting of MPN (MPN-SVT). Anticoagulation is the cornerstone of therapy and cytoreductive therapy is recommended per MPN treatment guidelines. Endovascular intervention may also be considered in patients with occlusive or extensive clot burden in the acute setting to prevent or mitigate potential portal hypertensive complications. Beyond these general approaches, there are still gaps in our knowledge of how to treat MPN-SVT, including the optimal dose and timing of anticoagulation, role of endovascular interventions and novel agents, and management of patients with MPN-SVT without elevated counts. Future studies will be needed to bridge the gap of these unmet needs. ABSTRACT: Patients who develop splanchnic vein thrombosis (SVT) in the setting of a myeloproliferative neoplasm (MPN) are at risk for complications including portal hypertension, bleeding, thrombosis, and death. Prompt multidisciplinary treatment is thus necessary to prevent long-term sequelae. However, optimal management strategies are not well established due to a paucity of data. In this review, we very briefly discuss the epidemiology, pathophysiology, and prognosis of MPN-SVT and then more comprehensively explore treatment considerations of MPN-SVT, including anticoagulation, endovascular/surgical intervention, and cytoreductive therapy. We will also highlight current gaps in our knowledge of MPN-SVT and conclude by suggesting future directions to optimize the treatment of MPN-SVT and improve outcomes. MDPI 2022-12-20 /pmc/articles/PMC9817858/ /pubmed/36612008 http://dx.doi.org/10.3390/cancers15010011 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Liu, Angela
Naymagon, Leonard
Tremblay, Douglas
Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs
title Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs
title_full Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs
title_fullStr Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs
title_full_unstemmed Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs
title_short Splanchnic Vein Thrombosis in Myeloproliferative Neoplasms: Treatment Considerations and Unmet Needs
title_sort splanchnic vein thrombosis in myeloproliferative neoplasms: treatment considerations and unmet needs
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817858/
https://www.ncbi.nlm.nih.gov/pubmed/36612008
http://dx.doi.org/10.3390/cancers15010011
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