Diagnosis, prevention, and management of bleeding episodes in Philadelphia-negative myeloproliferative neoplasms: recommendations by the Hemostasis Working Party of the German Society of Hematology and Medical Oncology (DGHO) and the Society of Thrombosis and Hemostasis Research (GTH)

Ann Hematol. 2016 Apr;95(5):707-18. doi: 10.1007/s00277-016-2621-2. Epub 2016 Feb 26.

Abstract

Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPN) comprise a heterogeneous group of chronic hematologic malignancies. The quality of life, morbidity, and mortality of patients with MPN are primarily affected by disease-related symptoms, thromboembolic and hemorrhagic complications, and progression to myelofibrosis and acute leukemia. Major bleeding represents a common and important complication in MPN, and the incidence of such bleeding events will become even more relevant in the future due to the increasing disease prevalence and survival of MPN patients. This review discusses the causes, differential diagnoses, prevention, and management of bleeding episodes in patients with MPN, aiming at defining updated standards of care in these often challenging situations.

Keywords: Bleeding; Essential thrombocythemia; Hemorrhage; MPN; Management; Myeloproliferative neoplasms; Polycythemia vera; Review.

Publication types

  • Consensus Development Conference
  • Practice Guideline
  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Blood Coagulation Factors / therapeutic use
  • Blood Loss, Surgical / prevention & control
  • Blood Transfusion
  • Blood Vessels / drug effects
  • Blood Vessels / pathology
  • Clinical Trials as Topic
  • Contraindications
  • Deamino Arginine Vasopressin / therapeutic use
  • Disease Management
  • Elective Surgical Procedures
  • Hemorrhage / diagnosis
  • Hemorrhage / etiology*
  • Hemorrhage / prevention & control
  • Hemorrhage / therapy
  • Hemostatic Techniques*
  • Humans
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / complications
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / drug therapy
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / genetics
  • Liver / physiopathology
  • Multicenter Studies as Topic
  • Myeloproliferative Disorders / complications*
  • Myeloproliferative Disorders / drug therapy
  • Myeloproliferative Disorders / genetics
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use
  • Platelet Function Tests
  • Platelet Transfusion
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / prevention & control
  • Postoperative Hemorrhage / therapy
  • Thrombophilia / drug therapy
  • Thrombophilia / etiology
  • Tranexamic Acid / therapeutic use
  • von Willebrand Diseases / etiology
  • von Willebrand Factor / analysis

Substances

  • Anticoagulants
  • Antineoplastic Agents
  • Blood Coagulation Factors
  • Platelet Aggregation Inhibitors
  • von Willebrand Factor
  • Tranexamic Acid
  • Deamino Arginine Vasopressin