Mechanisms of thrombogenesis in polycythemia vera

Abstract Thrombotic and cardiovascular events are among the leading causes of death for patients with polycythemia vera (PV), and thrombosis history is a key criterion for patient risk stratification and treatment strategy. Little is known, however, about mechanisms of thrombogenesis in patients wit...

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Bibliographic Details
Published in:Blood reviews 2015-07, Vol.29 (4), p.215-221
Main Authors: Kroll, Michael H, Michaelis, Laura C, Verstovsek, Srdan
Format: Article
Language:English
Subjects:
Hematology, Oncology and Palliative Medicine
Humans
Janus kinase 2
Polycythemia vera
Polycythemia Vera - drug therapy
Polycythemia Vera - physiopathology
Risk Factors
Thrombosis
Thrombosis - etiology
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Summary:Abstract Thrombotic and cardiovascular events are among the leading causes of death for patients with polycythemia vera (PV), and thrombosis history is a key criterion for patient risk stratification and treatment strategy. Little is known, however, about mechanisms of thrombogenesis in patients with PV. This report provides an overview of thrombogenesis pathophysiology in patients with PV and elucidates the roles of conventional and nonconventional thrombotic risk factors. In addition to several conventional risk factors for thrombosis, clinical data have implicated increased hematocrit and red blood cell adhesiveness, activated platelets, leukocytosis, and elevated JAK2V617F allele burden in patients with PV. Furthermore, PV-related inflammation may exacerbate thrombogenesis through varied mechanisms, including endothelial damage, inhibition of natural anticoagulant pathways, and secretion of procoagulant factors. These findings suggest a direct link between myeloproliferation and thrombogenesis in PV, which is likely to provide new opportunities for targeted antithrombotic interventions aimed at decreasing PV-related morbidity and mortality.
ISSN:0268-960X
1532-1681
DOI:10.1016/j.blre.2014.12.002