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<p>Thrombotic risk assessment is crucial in newly diagnosed essential thrombocythemia (ET) and polycythemia vera (PV) patients to guide cytoreductive therapy. We assessed whether thromboinflammation biomarkers would be good candidates to improve thrombosis risk stratification. We prospectively enrolled 394 newly diagnosed, cytoreductive therapy–naïve, ET and PV patients. We measured seven plasma biomarkers of neutrophil, monocyte, platelet, and endothelial activation, including NET markers, and evaluated their association with thrombosis risk scores at diagnosis. Multivariable analysis in the whole MPN cohort showed elevated calprotectin and tissue factor levels in high-risk versus low-risk patients using the conventional two-tiered score. This was also observed in ET patients only, but not in PV patients. Patients with a JAK2V617F allele burden &gt;20% showed higher levels of three markers, including calprotectin, supporting its role in immunothrombosis. In PV patients, calprotectin correlated with the Venous Thrombosis Score (VETS), and five markers were elevated in those with prior venous thrombosis. Lastly, aspirin use was associated with lower H3Cit levels in patients with normal platelet counts, confirming its beneficial effect on NET formation. This is the largest study to date linking thromboinflammation markers to thrombotic risk in MPN patients and identifying potential biomarkers for future thrombosis risk scores.</p>

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Thromboinflammation is associated with high thrombotic risk in patients with newly diagnosed myeloproliferative neoplasms

  • 期刊论文

  • 发表日期：

    2025年12月23日

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  • Alexandre Guy,
  • Olivier Mansier,
  • Matisse Decilap,
  • Alexandre Catherineau,
  • Geoffrey Garcia,
  • Sylvie Labrouche-Colomer,
  • Marie-Lise Bats,
  • Françoise Boyer,
  • Jean-Christophe Ianotto,
  • Eric Lippert,
  • Lydia Roy,
  • Suzanne Tavitian,
  • Borhane Slama,
  • Stéphane Girault,
  • Gabriel Etienne,
  • Anne Parry,
  • Arnaud Saint-Lezer,
  • Guillaume Denis,
  • Clémence Médiavilla,
  • Jean-François Viallard,
  • Laurence Legros,
  • Dana Ranta,
  • Mathieu Wemeau,
  • Franck-Emmanuel Nicolini,
  • François Lifermann,
  • Nathalie Cambier,
  • Luc Darnige,
  • François Girodon,
  • Juliette Soret-Dulphy,
  • Émilie Cayssials,
  • Fabienne Vacheret,
  • Léa Sureau,
  • Damien Luque Paz,
  • Valérie Ugo,
  • Jean-Jacques Kiladjian,
  • Rodolphe Thiébaut,
  • Chloe James,
  • Borhane Slama

摘要

Thrombotic risk assessment is crucial in newly diagnosed essential thrombocythemia (ET) and polycythemia vera (PV) patients to guide cytoreductive therapy. We assessed whether thromboinflammation biomarkers would be good candidates to improve thrombosis risk stratification. We prospectively enrolled 394 newly diagnosed, cytoreductive therapy–naïve, ET and PV patients. We measured seven plasma biomarkers of neutrophil, monocyte, platelet, and endothelial activation, including NET markers, and evaluated their association with thrombosis risk scores at diagnosis. Multivariable analysis in the whole MPN cohort showed elevated calprotectin and tissue factor levels in high-risk versus low-risk patients using the conventional two-tiered score. This was also observed in ET patients only, but not in PV patients. Patients with a JAK2V617F allele burden >20% showed higher levels of three markers, including calprotectin, supporting its role in immunothrombosis. In PV patients, calprotectin correlated with the Venous Thrombosis Score (VETS), and five markers were elevated in those with prior venous thrombosis. Lastly, aspirin use was associated with lower H3Cit levels in patients with normal platelet counts, confirming its beneficial effect on NET formation. This is the largest study to date linking thromboinflammation markers to thrombotic risk in MPN patients and identifying potential biomarkers for future thrombosis risk scores.