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dc.contributor.authorHultcrantz, Malin
dc.contributor.authorBjörkholm, Magnus
dc.contributor.authorDickman, Paul W.
dc.contributor.authorLandgren, Ola
dc.contributor.authorDerolf, Åsa R.
dc.contributor.authorKristinsson, Sigurdur Y.
dc.contributor.authorAndersson, Therese M.L.
dc.date.accessioned2018-05-22T14:26:13Z
dc.date.available2018-05-22T14:26:13Z
dc.date.issued2018-01-16
dc.date.submitted2018
dc.identifier.citationRisk for Arterial and Venous Thrombosis in Patients With Myeloproliferative Neoplasms 2018, 168 (5):317 Annals of Internal Medicineen
dc.identifier.issn0003-4819
dc.identifier.doi10.7326/M17-0028
dc.identifier.urihttp://hdl.handle.net/2336/620559
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractBACKGROUND: Patients with myeloproliferative neoplasms (MPNs) are reported to be at increased risk for thrombotic events. However, no population-based study has estimated this excess risk compared with matched control participants. OBJECTIVE: To assess risk for arterial and venous thrombosis in patients with MPNs compared with matched control participants. DESIGN: Matched cohort study. SETTING: Population-based setting in Sweden from 1987 to 2009, with follow-up to 2010. PATIENTS: 9429 patients with MPNs and 35 820 matched control participants. MEASUREMENTS: The primary outcomes were rates of arterial and venous thrombosis. Flexible parametric models were used to calculate hazard ratios (HRs) and cumulative incidence with 95% CIs. RESULTS: The HRs for arterial thrombosis among patients with MPNs compared with control participants at 3 months, 1 year, and 5 years were 3.0 (95% CI, 2.7 to 3.4), 2.0 (CI, 1.8 to 2.2), and 1.5 (CI, 1.4 to 1.6), respectively. The corresponding HRs for venous thrombosis were 9.7 (CI, 7.8 to 12.0), 4.7 (CI, 4.0 to 5.4), and 3.2 (CI, 2.9 to 3.6). The rate was significantly elevated across all age groups and was similar among MPN subtypes. The 5-year cumulative incidence of thrombosis in patients with MPNs showed an initial rapid increase followed by gentler increases during follow-up. The HR for venous thrombosis decreased during more recent calendar periods. LIMITATION: No information on individual laboratory results or treatment. CONCLUSION: Patients with MPNs across all age groups have a significantly increased rate of arterial and venous thrombosis compared with matched control participants, with the highest rates at and shortly after diagnosis. Decreases in the rate of venous thrombosis over time likely reflect advances in clinical management. PRIMARY FUNDING SOURCE: The Cancer Research Foundations of Radiumhemmet, Blodcancerfonden, the Swedish Research Council, the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, the Adolf H. Lundin Charitable Foundation, and Memorial Sloan Kettering Cancer Center.
dc.description.sponsorshipCancer Research Foundations of Radiumhemmet, Blodcancerfonden Swedish Research Council Adolf H. Lundin Charitable Foundation Memorial Sloan Kettering Cancer Centeren
dc.language.isoenen
dc.publisherAmerican College of Physicians - American Society of Internal Medicineen
dc.relation.urlhttp://annals.org/article.aspx?doi=10.7326/M17-0028en
dc.rightsArchived with thanks to Annals of Internal Medicineen
dc.subjectKrabbameinen
dc.subjectBlóðtappien
dc.subjectHEM12en
dc.subject.meshMyeloproliferative Disordersen
dc.subject.meshThrombosisen
dc.titleRisk for Arterial and Venous Thrombosis in Patients With Myeloproliferative Neoplasmsen
dc.typeArticleen
dc.contributor.department[ 1 ] Karolinska Univ Hosp, Stockholm, Sweden Show more [ 2 ] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden Show more [ 3 ] Karolinska Univ Hosp Solna, Dept Med, Div Hematol, SE-17176 Stockholm, Sweden Show more [ 4 ] Mem Sloan Kettering Canc Ctr, Dept Med, Myeloma Serv, 1275 York Ave, New York, NY 10065 USA Show more [ 5 ] Univ Iceland, Fac Med, Hringbraut 101, IS-101 Reykjavik, Iceland Show more [ 6 ] Landspitali Natl Univ Hosp, Reykjavik, Icelanden
dc.identifier.journalAnnals of Internal Medicineen
dc.rights.accessLandspitali Access - LSH-aðganguren
dc.contributor.institutionKarolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, and Memorial Sloan Kettering Cancer Center, New York, New York (M.H.)
dc.contributor.institutionKarolinska University Hospital and Karolinska Institutet, Stockholm, Sweden (M.B., Å.R.D.)
dc.contributor.institutionKarolinska Institutet, Stockholm, Sweden (P.W.D., T.M.A.)
dc.contributor.institutionMemorial Sloan Kettering Cancer Center, New York, New York (O.L.)
dc.contributor.institutionKarolinska University Hospital and Karolinska Institutet, Stockholm, Sweden (M.B., Å.R.D.)
dc.contributor.institutionKarolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, and University of Iceland and Landspítali National University Hospital, Reykjavik, Iceland (S.Y.K.)
dc.contributor.institutionKarolinska Institutet, Stockholm, Sweden (P.W.D., T.M.A.)
dc.departmentcodeHEM12
html.description.abstractBACKGROUND: Patients with myeloproliferative neoplasms (MPNs) are reported to be at increased risk for thrombotic events. However, no population-based study has estimated this excess risk compared with matched control participants. OBJECTIVE: To assess risk for arterial and venous thrombosis in patients with MPNs compared with matched control participants. DESIGN: Matched cohort study. SETTING: Population-based setting in Sweden from 1987 to 2009, with follow-up to 2010. PATIENTS: 9429 patients with MPNs and 35 820 matched control participants. MEASUREMENTS: The primary outcomes were rates of arterial and venous thrombosis. Flexible parametric models were used to calculate hazard ratios (HRs) and cumulative incidence with 95% CIs. RESULTS: The HRs for arterial thrombosis among patients with MPNs compared with control participants at 3 months, 1 year, and 5 years were 3.0 (95% CI, 2.7 to 3.4), 2.0 (CI, 1.8 to 2.2), and 1.5 (CI, 1.4 to 1.6), respectively. The corresponding HRs for venous thrombosis were 9.7 (CI, 7.8 to 12.0), 4.7 (CI, 4.0 to 5.4), and 3.2 (CI, 2.9 to 3.6). The rate was significantly elevated across all age groups and was similar among MPN subtypes. The 5-year cumulative incidence of thrombosis in patients with MPNs showed an initial rapid increase followed by gentler increases during follow-up. The HR for venous thrombosis decreased during more recent calendar periods. LIMITATION: No information on individual laboratory results or treatment. CONCLUSION: Patients with MPNs across all age groups have a significantly increased rate of arterial and venous thrombosis compared with matched control participants, with the highest rates at and shortly after diagnosis. Decreases in the rate of venous thrombosis over time likely reflect advances in clinical management. PRIMARY FUNDING SOURCE: The Cancer Research Foundations of Radiumhemmet, Blodcancerfonden, the Swedish Research Council, the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, the Adolf H. Lundin Charitable Foundation, and Memorial Sloan Kettering Cancer Center.


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