Blood clots: a significant complication in MPN

MPN patients are at a higher risk than others for developing blood clots. The Leukaemia Foundation’s MPN booklet advises that both bleeding and blood clots can be caused by MPNs. “Blood clots are a significant complication in MPN. Blood clots block blood vessels or arteries and are known as vascular or thrombotic events, such as heart attacks or strokes.  They are serious and need urgent medical attention.”

It is important to know the signs and symptoms of blood clots, these can vary depending on where the blood clot is.

How to recognise if you have developed a blood clot

Blood clots can develop in the arteries (arterial thrombosis) or in the veins (venous thrombosis).

Pictorials courtesy of ‘Stop the Clot:World thrombosis day

Infographic explaining thrombosis types

More detail on venous thromboses

Why do MPN patients clot?

Dr Cecily Forsyth’s presentation on thrombosis
Dr Cecily Forsyth covers the risk factors for MPN patients and provides many relatively simple ways to address those risk factors. We highly recommend viewing her video and/or her accompanying powerpoint presentation – HERE

Overview: reducing venous thromboembolism and arterial thrombosis
(below are two screenshots from Dr Forsyth’s presentation)

prevention of venous thrombosis

prevention of arterial thrombosis

Polycythemia vera patients’ haematocrit

Polycythemia vera patients’ haematocrit needs to be kept below .45 to reduce thrombosis risk.
And for women, haematologists often prefer to keep haematocrit below .42.
See Cardiovascular Events and Intensity of Treatment in Polycythemia Vera.

Myelofibrosis patients – nuanced care

US cardiologist, Dr Orly Leiva, who has a special interest in MPNs, points out that while blood clotting is a known complication in MPN patients, thrombosis can still be a high risk for myelofibrosis (MF) patients, especially those who DON’T have low blood counts. His research shows that one in 8 MF patients may develop a blood clot.

He explains that MPNs are a pro clotting disorder so mitigation risk is important – but this needs to be very nuanced to find a perfect balance in MF patients due to the risk of bleeding as well.
For more information on thrombosis in MF, his video presentation at the 5 minute mark refers HERE.

How does cardiovascular health fit in with thrombosis risk?

The MPN AA’s page about cardiovascular health and MPNs has further information on MPNs and cardiovascular health and features further details from cardiologist Dr Leiva.

Additional links to patient resources about blood clots

The Thrombosis and Haemostatis society of Australia and New Zealand as well as the Clinical Excellence Commission in NSW also have developed patient resources.

    1. Blood clot prevention
      How to prevent a blood clot developing
    2. Further blood clots – prevention
      How to prevent another clot developing 
    3. More information about the different types of clots.
      Deep vein thrombosis
      Pulmonary embolism
      Splanchnic vein thrombosis  (an article about MPNs and splanchnic vein thrombosis)
    4. Travel and preventing blood clots
      Practical in flight fitness tips to help avoid blood clots (courtesy of ‘Stop the Clot’)
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