Blood Res.  2020 Jun;55(2):77-84. 10.5045/br.2020.2020001.

Pulmonary hypertension in patients with Philadelphia-negative myeloproliferative neoplasms: a single-center retrospective analysis of 225 patients

• Lee MW
• Ryu H
• Choi YS
• Song IC
• Lee HJ
• Yun HJ
• Sun BJ
• Jeong JO
• Jo DY

• KMID: 2503481
• DOI: http://doi.org/10.5045/br.2020.2020001

Abstract

Background
The prevalence of pulmonary hypertension (PH) in myeloproliferative neoplasms (MPNs) varies among studies. We analyzed the prevalence of PH in Korean patients with Philadelphia-negative (Ph-) MPNs.
Methods
Medical records of patients with Ph- MPNs [essential thrombocythemia (ET), polycythemia vera (PV), or primary myelofibrosis (PMF)] visiting a single hospital between 1993 and 2019 were reviewed retrospectively. Transthoracic echocardiographic examination (TTE) results were reviewed and PH was diagnosed according to established guidelines.
Results
Of the 320 MPN (179 ET, 107 PV, and 34 PMF) patients, 225 (121 ET, 83 PV, and 21 PMF) underwent TTE. Of these 225 MPN patients, 19 of 121 (15.7%) ET, 9 of 83 (10.8%) PV, and 6 of 21 (28.6%) PMF patients had PH. PV patients with PH were older [71 (42‒85) vs. 61.5 (26‒91) yr, respectively; P =0.049], predominantly female (male:female ratio, 0.29 vs. 1.96, respectively; P =0.010), had lower hemoglobin levels (15.9±2.6 g/dL vs. 18.4±2.6 g/dL, respectively; P =0.010), and higher platelet counts (616.6±284.2×109/L vs. 437.7±191.7×109/L, respectively; P =0.020) than PV patients without PH. PMF patients with PH had higher monocyte counts (1.3±0.5×109/L vs. 0.8±0.4×109/L, respectively; P =0.031) than those without PH. PH was a risk factor for poor survival in PV (HR, 12.4; 95% CI, 1.8‒86.6).
Conclusion
PH is common in patients with Ph- MPNs and hence, careful screening for PH is warranted.

Keyword

Myeloproliferative neoplasm; Essential thrombocytopenia; Polycythemia vera; Primary myelofibrosis; Pulmonary hypertension

Figure

• 

  Fig. 1 Overall survival of patients with MPNs according to pulmonary hypertension. Essential thrombocythemia (A). Polycythemia vera (B). Primary myelofibrosis (C). All MPN patients (D). Abbreviations: MPNs, myeloproliferative neoplasms; OS, overall survival; PH, pulmonary hypertension.

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