Arterial thrombosis in Philadelphia-negative myeloproliferative neoplasms predicts second cancer: a case-control study

Blood. 2020 Jan 30;135(5):381-386. doi: 10.1182/blood.2019002614.


Patients with Philadelphia-negative myeloproliferative neoplasm (MPN) are prone to the development of second cancers, but the factors associated with these events have been poorly explored. In an international nested case-control study, we recruited 647 patients with carcinoma, nonmelanoma skin cancer, hematological second cancer, and melanoma diagnosed concurrently or after MPN diagnosis. Up to 3 control patients without a history of cancer and matched with each case for center, sex, age at MPN diagnosis, date of diagnosis, and MPN disease duration were included (n = 1234). Cases were comparable to controls for MPN type, driver mutations and cardiovascular risk factors. The frequency of thrombosis preceding MPN was similar for cases and controls (P = .462). Thrombotic events after MPN and before second cancer were higher in cases than in controls (11.6% vs 8.1%; P = .013), because of a higher proportion of arterial thromboses (6.2% vs 3.7%; P = .015). After adjustment for confounders, the occurrence of arterial thrombosis remained independently associated with the risk of carcinoma (odds ratio, 1.97; 95% confidence interval, 1.14-3.41), suggesting that MPN patients experiencing arterial events after MPN diagnosis deserve careful clinical surveillance for early detection of carcinoma. This study was registered at as NCT03745378.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arteries / pathology*
  • Case-Control Studies
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Multivariate Analysis
  • Myeloproliferative Disorders / pathology*
  • Neoplasms, Second Primary / pathology*
  • Philadelphia Chromosome*
  • Thrombosis / pathology*

Associated data