Thrombosis and hemorrhage in myeloproliferative neoplasms: The platelet perspective

Abstract

Classical myeloproliferative neoplasm (MPN), also known as BCR-ABL-negative MPN, is a clonal disease characterized by abnormal expansion of hematopoietic stem cells. It has been demonstrated that MPN patients are more susceptible to thrombotic events compared to the general population. Therefore, researchers have been exploring the treatment for MPN thrombosis. However, antithrombotic therapies have brought another concern for the clinical management of MPN because they may cause bleeding events. When thrombosis and bleeding, two seemingly contradictory complications, occur in MPN patients at the same time, they will lead to more serious consequences. Therefore, it is a major challenge to achieving the best antithrombotic effect and minimizing bleeding events simultaneously. To date, there has yet been a perfect strategy to meet this challenge and therefore a new treatment method needs to be established. In this article, we describe the mechanism of thrombosis and bleeding events in MPN from the perspective of platelets for the first time. Based on the double-sided role of platelets in MPN, optimal antithrombotic treatment strategies that can simultaneously control thrombosis and bleeding at the same time may be formulated by adjusting the administration time and dosage of antiplatelet drugs. We argue that more attention should be paid to the critical role of platelets in MPN thrombosis and MPN bleeding in the future, so as to better manage adverse vascular events in MPN.

Keywords:

• Hemorrhage
• inflammation
• myeloproliferative neoplasms
• platelets
• thrombosis

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Author Contributions

YF made substantial contributions to the conception and design of the study, creation of figures, and analysis of the data, JS revising it critically for important intellectual content and provides positive suggestions for manuscript. All authors contributed to the final approval of the version to be published.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.