The Role of Direct Oral Anticoagulants in Managing Myeloproliferative Neoplasms Patients
- Author:
Ji Yun LEE
1
;
Ju-Hyun LEE
;
Woochan PARK
;
Jeongmin SEO
;
Minsu KANG
;
Eun Hee JUNG
;
Sang-A KIM
;
Koung Jin SUH
;
Ji-Won KIM
;
Se Hyun KIM
;
Jeong-Ok LEE
;
Jin Won KIM
;
Yu Jung KIM
;
Keun-Wook LEE
;
Jee Hyun KIM
;
Soo-Mee BANG
Author Information
- Publication Type:Original Article
- From:Cancer Research and Treatment 2025;57(2):612-620
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Thrombosis and bleeding significantly affect morbidity and mortality in myeloproliferative neoplasms (MPNs). The efficacy and safety of direct oral anticoagulants (DOACs) in MPN patients remain uncertain.
Materials and Methods:We conducted a large, retrospective, nationwide cohort study using the Korean Health Insurance Review and Assessment Service database from 2010 to 2021.
Results:Out of the 368 MPN patients included in the final analysis, 62.8% were treated with DOACs for atrial fibrillation (AF), and 37.2% for venous thromboembolism (VTE). The AF group was statistically older with higher CHA2DS2-VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, prior stroke, transient ischemic attack, or thromboembolism, vascular disease, age 65-74 years, sex category [female]) scores compared to the VTE group. Antiplatelet agents were used in 51.1% of cases, and cytoreductive drugs in 79.3%, with hydroxyurea being the most common (64.9%). The median follow-up was 22.3 months, with 1-year cumulative incidence rates of thrombosis and bleeding at 11.1% and 3.7%, respectively. Multivariate analysis identified CHA2DS2-VASc scores ≥ 3 (hazard ratio [HR], 3.48), concomitant antiplatelet use (HR, 2.57), and cytoreduction (HR, 2.20) as significant thrombosis risk factors but found no significant predictors for major bleeding.
Conclusion:Despite the limitations of retrospective data, DOAC treatment in MPN patients seems effective and has an acceptable bleeding risk.
