Abstract：
BACKGROUND: Optimal anticoagulation management in patients with myeloproliferative neoplasms (MPN) experiencing splanchnic vein thrombosis (SpVT) requires balancing risks of bleeding and recurrent thrombosis.
OBJECTIVE: We conducted a systematic review and meta-analysis to assess the incidence of bleeding and thrombosis recurrence in patients with MPN-SpVT.
METHODS: We included retrospective or prospective studies in English with ≥10 adult patients with MPN-SpVT. Outcomes included recurrent venous thrombosis (SpVT and non-SpVT), arterial thrombosis, and major bleeding. Pooled rates per 100 patient years with 95% CIs were calculated by DerSimonian-Laird method using random-effects model.
RESULTS: Out of 4624 studies screened, 9 studies with a total of 443 patients were included in the meta-analysis with median follow-up of 3.5 years. In the 364 patients with MPN-SpVT treated with anticoagulation, pooled event rate for major bleeding was 2.8 (95% CI, 1.5-5.1; I2 = 95%), for recurrent venous thrombosis was 1.4 (95% CI, 0.8-2.2; I2 = 72%), and for arterial thrombosis was 1.4 (95% CI, 0.6-3.3; I2 = 92%) per 100 patient years. Among 79 patients (n = 4 studies) who did not receive anticoagulation, pooled event rate for major bleeding was 3.2 (95% CI, 0.7-12.7; I2 = 97%), for recurrent venous thrombosis 3.5 (95% CI, 1.8-6.4; I2 = 88%), and for arterial thrombosis rate 1.6 (95% CI, 0.4-6.6; I2 = 95%) per 100 patient years.
CONCLUSIONS: Patients with MPN-SpVT treated with anticoagulation have significant risks for both major bleeding and thrombosis recurrence. Further studies are necessary to determine the optimal anticoagulation approach in patients with MPN-SpVT.
OBJECTIVE: We conducted a systematic review and meta-analysis to assess the incidence of bleeding and thrombosis recurrence in patients with MPN-SpVT.
METHODS: We included retrospective or prospective studies in English with ≥10 adult patients with MPN-SpVT. Outcomes included recurrent venous thrombosis (SpVT and non-SpVT), arterial thrombosis, and major bleeding. Pooled rates per 100 patient years with 95% CIs were calculated by DerSimonian-Laird method using random-effects model.
RESULTS: Out of 4624 studies screened, 9 studies with a total of 443 patients were included in the meta-analysis with median follow-up of 3.5 years. In the 364 patients with MPN-SpVT treated with anticoagulation, pooled event rate for major bleeding was 2.8 (95% CI, 1.5-5.1; I2 = 95%), for recurrent venous thrombosis was 1.4 (95% CI, 0.8-2.2; I2 = 72%), and for arterial thrombosis was 1.4 (95% CI, 0.6-3.3; I2 = 92%) per 100 patient years. Among 79 patients (n = 4 studies) who did not receive anticoagulation, pooled event rate for major bleeding was 3.2 (95% CI, 0.7-12.7; I2 = 97%), for recurrent venous thrombosis 3.5 (95% CI, 1.8-6.4; I2 = 88%), and for arterial thrombosis rate 1.6 (95% CI, 0.4-6.6; I2 = 95%) per 100 patient years.
CONCLUSIONS: Patients with MPN-SpVT treated with anticoagulation have significant risks for both major bleeding and thrombosis recurrence. Further studies are necessary to determine the optimal anticoagulation approach in patients with MPN-SpVT.
摘要：
背景：对于经历内脏静脉血栓形成（SpVT）的骨髓增殖性肿瘤（MPN）患者，最佳抗凝治疗需要平衡出血和复发性血栓形成的风险。
目的：我们进行了系统评价和荟萃分析，以评估MPN-SpVT患者出血和血栓复发的发生率。
方法：我们纳入了10名以上成人MPN-SpVT患者的英文回顾性或前瞻性研究。结果包括复发性静脉血栓形成（SpVT和非SpVT），动脉血栓形成,大出血.使用随机效应模型，通过DerSimonian-Laird方法计算每100名患者年的合并率，置信区间为95％（CI）。
结果：在筛选的4624项研究中，9项研究共443例患者纳入荟萃分析，中位随访时间为3.5年。在接受抗凝治疗的364例MPN-SpVT患者中，大出血的合并事件率为2.8(95%CI1.5-5.1;I2=95%),复发性静脉血栓形成为1.4(95%CI0.8~2.2;I2=72%),动脉血栓形成为1.4(95%CI0.6~3.3;I2=92%)/100患者年.在79例未接受抗凝治疗的患者（n=4项研究）中，大出血的合并事件率为3.2(95%CI0.7-12.7;I2=97%),每100例患者年的复发性静脉血栓形成率为3.5(95%CI1.8-6.4;I2=88%),动脉血栓形成率为1.6(95%CI0.4-6.6;I2=95%).
结论：接受抗凝治疗的MPN-SpVT患者具有严重出血和血栓复发的显著风险。需要进一步的研究来确定MPN-SpVT患者的最佳抗凝方法。
目的：我们进行了系统评价和荟萃分析，以评估MPN-SpVT患者出血和血栓复发的发生率。
方法：我们纳入了10名以上成人MPN-SpVT患者的英文回顾性或前瞻性研究。结果包括复发性静脉血栓形成（SpVT和非SpVT），动脉血栓形成,大出血.使用随机效应模型，通过DerSimonian-Laird方法计算每100名患者年的合并率，置信区间为95％（CI）。
结果：在筛选的4624项研究中，9项研究共443例患者纳入荟萃分析，中位随访时间为3.5年。在接受抗凝治疗的364例MPN-SpVT患者中，大出血的合并事件率为2.8(95%CI1.5-5.1;I2=95%),复发性静脉血栓形成为1.4(95%CI0.8~2.2;I2=72%),动脉血栓形成为1.4(95%CI0.6~3.3;I2=92%)/100患者年.在79例未接受抗凝治疗的患者（n=4项研究）中，大出血的合并事件率为3.2(95%CI0.7-12.7;I2=97%),每100例患者年的复发性静脉血栓形成率为3.5(95%CI1.8-6.4;I2=88%),动脉血栓形成率为1.6(95%CI0.4-6.6;I2=95%).
结论：接受抗凝治疗的MPN-SpVT患者具有严重出血和血栓复发的显著风险。需要进一步的研究来确定MPN-SpVT患者的最佳抗凝方法。
