Pulmonary hypertension in patients with Philadelphia-negative myeloproliferative neoplasms: a single-center retrospective analysis of 225 patients
Myung-Won Lee, Hyewon Ryu, Yoon-Seok Choi, Ik-Chan Song, Hyo-Jin Lee, Hwan-Jung Yun, Byung Joo Sun, Jin-Ok Jeong, Deog-Yeon Jo
Division of Hematology/Oncology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
Correspondence to: Deog-Yeon Jo, M.D., Ph.D.
Division of Hematology/Oncology, Department of Internal Medicine, Chungnam National University Hospital, 282 Munwha-ro, Jung-gu, Daejeon 35015, Korea
E-mail: deogyeon@cnu.ac.kr
Published online: May 20, 2020.
© The Korean Journal of Hematology. All rights reserved.

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.
Keywords: Myeloproliferative neoplasm, Essential thrombocytopenia, Polycythemia vera, Primary myelofibrosis, Pulmonary hypertension


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