Arterial and venous thromboses are the most significant complications in patients with myeloproliferative neoplasms (MPN), with the primary treatment goal being thrombotic risk reduction. In MPN with no history of thrombosis, primary prevention mainly involves the use of aspirin and cytoreduction is added in high-risk patients. However, thrombotic complications can unveil an MPN in approximately 20% of cases, necessitating the initiation of both antithrombotic therapy for the thrombosis and cytoreductive treatment for the MPN. The duration of anticoagulant therapy following an initial venous thromboembolic event (VTE) is subject to discussion. Furthermore, the occurrence of a thrombotic complication in patients with a known diagnosis of MPN prompts a reconsideration of both antithrombotic and hematological management. This review employs case-based discussions to explore the management of thrombotic complications in MPN patients. It addresses the nature and duration of antithrombotic treatments, as well as the approach to cytoreduction. Special attention is given to the place of direct oral anticoagulants and to the management of MPN patients with splanchnic vein thrombosis, which is disproportionately common in this group.

中文翻译：

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我如何处理骨髓增生性肿瘤患者血栓并发症的治疗。


动脉和静脉血栓形成是骨髓增生性肿瘤 （MPN） 患者最严重的并发症，主要治疗目标是降低血栓形成风险。在无血栓形成史的 MPN 中，一级预防主要涉及使用阿司匹林，并在高危患者中增加细胞减灭术。然而，在大约 20% 的病例中，血栓形成并发症可揭示 MPN，因此需要开始血栓形成的抗血栓治疗和 MPN 的细胞减灭治疗。初始静脉血栓栓塞事件 （VTE） 后抗凝治疗的持续时间有待讨论。此外，已知诊断为 MPN 的患者发生血栓并发症促使重新考虑抗血栓形成和血液学管理。本综述采用基于病例的讨论来探讨 MPN 患者血栓形成并发症的管理。它讨论了抗血栓治疗的性质和持续时间，以及细胞减灭术的方法。特别注意直接口服抗凝剂的位置和内脏静脉血栓形成 MPN 患者的管理，这在该组中不成比例地常见。