Pathogenesis of cardiovascular events in BCR-ABL1-negative myeloproliferative neoplasms

Area of Science:

• Hematology
• Oncology
• Cardiovascular Medicine

Background:

• Thrombosis is a major complication of myeloproliferative neoplasms (MPNs), leading to significant morbidity and mortality.
• Current risk factors include age >60 and prior thrombosis, but complex mechanisms involving blood cells, plasma factors, and endothelium contribute.
• Arterial vasospasm may also play a role in MPN-related thrombotic events.

Purpose of the Study:

• To review recent findings from mouse models and clinical studies on thrombosis in MPNs.
• To highlight potential novel therapeutic targets beyond current treatments.
• To focus on neutrophil extracellular traps and vascular reactivity as promising targets.

Main Methods:

• Review of recent preclinical data from mouse models.
• Analysis of existing clinical study data.
• Synthesis of information on thrombosis mechanisms in MPNs.

Main Results:

• Multiple blood cell types, plasma factors, and endothelial cells contribute to MPN-associated thrombosis.
• Neutrophil extracellular traps (NETs) and altered vascular reactivity are implicated in thrombotic risk.
• These factors represent potential targets for novel therapeutic strategies.

Conclusions:

• Understanding the multifaceted mechanisms of thrombosis in MPNs is crucial.
• Neutrophil extracellular traps and vascular reactivity are promising, yet untargeted, therapeutic avenues.
• Targeting these novel pathways could improve outcomes for MPN patients.