impact factor, citescore
logo
In press
In Press
Recent issue
Recent issue
Recent Supplement
Recent supplement
archives
Archives
articles free
Free to view
Search
Search
 

Full Papers

 

Venous thromboembolism during systemic inflammatory and autoimmune diseases associated with myelodysplastic syndromes, chronic myelomonocytic leukaemia and myelodysplastic/myeloproliferative neoplasms: a French multicentre retrospective case-control study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54

 

  1. Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France.
  2. Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France.
  3. Normandie Université, UNIROUEN, Service de Médecine Interne, INSERM U1096, Rouen, France.
  4. Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France.
  5. CHU de Clermont-Ferrand, Service d’Hématologie, Clermont-Ferrand, France.
  6. CHU Bichat APHP, Service de Dermatologie, Paris, France.
  7. CH Chalon sur Saône, service d’Hématologie-Oncologie, Chalon sur Saône, France.
  8. CHU de Bordeaux-Haut Levêque, Service d’Hématologie, Pessac, France.
  9. CH de la Côte Basque, Service d’Hématologie, Bayonne, France.
  10. CHU Bichat APHP, Service de Dermatologie, Paris, France.
  11. CHU Bichat APHP, Service de Médecine Interne, Paris, France.
  12. CHU Cochin, Service d’Hématologie, Paris, France.
  13. CH Dax-Côte d’Argent, Service de Medecine Interne, Dax, France.
  14. CHU Nîmes, Service de Médecine Interne, Nîmes, France.
  15. CHU Nîmes, Service de Médecine Interne, Nîmes, France.
  16. CHU Henri Mondor APHP, Service de Médecine Interne, Créteil, France.
  17. Paris Saclay Université, CHU Kremlin-Bicêtre, Service de Médecine Interne, Le Kremlin Bicêtre, France.
  18. CH Le Mans, Service d’Hématologie, Le Mans, France.
  19. CHU Ambroise Paré APHP, Service d’Hématologie, Boulogne-Billancourt, France.
  20. CHU Hôpital de la Conception APHM, Service de Néphrologie, Marseille, France.
  21. CHU de Nice Côte d’Azur, Service de Médecine Interne, Nice, France.
  22. CHU d’Angers, Service d’Hématologie, Angers, France.
  23. CHU Grenoble, Service d’Hématologie, Grenoble, France.
  24. CH de Cornouailles Quimper Concarneau, Service de Médecine Interne-Maladies Infectieuses, Maladies du Sang, Quimper, France.
  25. CH Pierre-Oudot Groupe Hospitalier Nord Dauphiné, Service de Médecine Interne, Bourgoin-Jallieu, France.
  26. Université de Lille, Hôpital Claude Huriez, Service de Médecine Interne et Immunologie Clinique, Lille, France.
  27. Université de Lille, Hôpital Claude Huriez, Service de Médecine Interne et Immunologie Clinique, Lille, France.
  28. CHU Necker-Enfants Malades APHP, Service d’Hématologie Adultes, Paris, France.
  29. CH Bourg-En-Bresse, Service Médecine Interne, Bourg-En-Bresse, France.
  30. CHU Rennes, Service de Médecine Interne et Immunologie Clinique, Inserm, CIC 1414, Rennes, France.
  31. CHU de Nantes, Service d’Hématologie Clinique, Nantes, France.
  32. CHU de Nantes, Service d’Hématologie Clinique, Nantes, France.
  33. CHU La Pitié Salpétrière APHP, Service de Gériatrie, Paris, France.
  34. CHU Cochin, Service d’Hématologie, Paris, France.
  35. CH Foch, Service de Médecine Interne, Suresnes, France.
  36. CHU Hôpital Européen Georges Pompidou APHP, Service de Gériatrie, Paris, France.
  37. Institut de Cancérologie Daniel Hollard Groupe Hospitalier Mutualiste de Grenoble, Service d’Oncologie, Grenoble, France.
  38. Institut Mutualiste Montsouris, Service de Médecine Interne, Paris, France.
  39. CHRU Besançon, Service d’Hématologie, Besançon, France.
  40. CHU Cochin, Service de Médecine Interne, Paris, France.
  41. CHU Cochin, Service de Médecine Interne, Paris, France.
  42. CH de Niort, Service de Médecine Interne, Niort, France.
  43. Institut Universitaire du Cancer de Toulouse, Service de Médecine Interne et Immunopathologie Clinique, Toulouse, France.
  44. CHU Estaing de Clermont-Ferrand, Service de Médecine Interne, Clermond-Ferrand, France.
  45. CHU Amiens Nord, Service de Médecine Interne, Amiens, France.
  46. CHU Rennes, Service de Médecine Interne et Immunologie Clinique, Inserm, CIC 1414, Rennes, France.
  47. CHU Henri Mondor APHP, Département d’Aval des Urgences, Créteil, France.
  48. CHU UCL Namur-Site Godinne, Service d’Hématologie, Yvoir, Belgium.
  49. CH de la Rochelle, Service de Médecine Interne et Hématologie, La Rochelle, France.
  50. CHU de Poitiers, Service de Médecine Interne-Maladies infectieuses et Tropicales, Poitiers, France.
  51. CHU Saint-Louis APHP, Service d’Hématologie Clinique, Université Paris VII, Paris, France.
  52. CHU Saint-Louis APHP, Service d’Hématologie Clinique, Université Paris VII, Paris, France.
  53. Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France.
  54. Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Paris, France. arsene.mekinian@aphp.fr

on behalf of MINHEMON (French Network of Dysimmune Disorders Associated wit Hemopathies) and GFM

CER14735
2022 Vol.40, N°7
PI 1336, PF 1342
Full Papers

Free to view
(click on article PDF icon to read the article)

PMID: 35579092 [PubMed]

Received: 19/04/2021
Accepted : 19/07/2021
In Press: 16/05/2022
Published: 04/07/2022

Abstract

OBJECTIVES:
Myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML) are associated with systemic inflammatory and autoimmune diseases (SIADs) in 10–30% of cases. The aims of this study were (i) to evaluate the prevalence of venous thromboembolism VTE in patients presenting with both MDS/CMML and SIADs, (ii) to describe risk factors associated with thrombosis, and (iii) to analyse the impact of VTE on overall survival and transformation to acute myeloid leukaemia in comparison to patients with MDS/CMML-associated SIADs without VTE.
METHODS:
This retrospective multicentre case-control study was conducted among patients with MDS/CMML and dysimmune disorders and featured in the French retrospective database of the French Network of Dysimmune Disorders Associated with Hemopathies (MINHEMON), diagnosed with MDS/CMML and dysimmune disorders.
RESULTS:
During a median follow-up of 16 months (5–48) VTE occurred in 35 patients (21.6 %) whereas 127 patients did not. Among those with VTE, 8 patients (22.9%) experienced two or more VTE. Common prothrombotic risk factors were not significantly different in patients with or without VTE. CMML was more frequent in patients without VTE (37 % vs. 14.3%, p=0.01), whereas myelodysplasic/myeloproliferative neoplasm (MDS/MPN) was higher in VTE patients (20 % vs. 5.5 %, p=0.01). In a multivariate analysis, only MDS/CMML progression at the time of VTE (odds ratio 28.82, 95 % CI (5.52–530.70) was significantly associated with VTE. When treated with an anticoagulation therapy, bleeding occurred in 19.4% of cases (6/31). Overall survival was not significantly different between patients with and without VTE (p=0.68). Leukaemia-free survival between groups was not significantly different (p=0.83).
CONCLUSIONS:
VTE is a common complication in MDS/CMML-associated SIADSs with an increased risk of bleeding when treated by anticoagulants. In the MDS/CMML subgroup, SIADS flares and MDS/CMML progression seem to be prothrombotic risk factors.

DOI: https://doi.org/10.55563/clinexprheumatol/nbn38d

Rheumatology Article