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Chronic myeloproliferative neoplasms

A prospective evaluation of pegylated interferon alfa-2a therapy in patients with polycythemia vera and essential thrombocythemia with a prior splanchnic vein thrombosis

Leukemia volume 33, pages 2974–2978 (2019)Cite this article

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Essential thrombocythemia (ET) and polycythemia vera (PV) are myeloproliferative neoplasms (MPNs) characterized by an increased risk of developing venous and arterial thromboses and of evolution to myelofibrosis or acute leukemia [1]. MPNs are recognized as a major cause of splanchnic vein thromboses (SVT), which include hepatic, splenic, portal, and mesenteric vein thromboses [2]. Patients with SVT are at an increased risk of developing bleeding events and arterial thrombotic events [3], as well as recurrent SVT and the use of anticoagulation and cytoreduction do not clearly modify this risk [3,4,5].

Management of SVT in MPN patients remains a challenge and most therapeutic recommendations are based on retrospective analyses [6]. Recently, De Stefano reported that hydroxyurea failed to prevent recurrent thromboses in the splanchnic vasculature in patients with a prior SVT [7]. We conducted a prospective, open-label, multi-center phase II clinical trial of Pegylated Interferon Alfa-2a (PEG) in 20 subjects with SVT and an MPN, who represented a cohort of patients who participated in the Myeloproliferative Disorders - Research Consortium (MPD-RC) 111 trial (NCT01259817). MPD-RC 111 was a prospective study of patients with high-risk ET/PV who were resistant or intolerant to hydroxyurea (HU), but prior HU therapy was not a requirement for patients to enter the SVT cohort. Here we report the outcomes of the 20 SVT patients who were treated with PEG.

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Acknowledgements

This research was made possible by a grant from the National Cancer Institute of the National Institute of Health (MPN Research Consortium Grant, 5P01CA108671–09) and generous independent, unrestricted support from Roche Genentech.

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Authors and Affiliations

  1. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    J. Mascarenhas, M. Kremyanskaya, L. Sandy & R. Hoffman

  2. Mayo Clinic, Scottsdale, AZ, USA

    H. Kosiorek & A. C. Dueck

  3. Division of Hematology, University of Utah School of Medicine, Salt Lake City, UT, USA

    J. Prchal

  4. University of Kansas Cancer Center, Kansas City, KS, USA

    A. Yacoub

  5. Comprehensive Cancer Center, Wake Forest University Medical Center, Wake Forest Health, Winston-Salem, NC, USA

    D. Berenzon

  6. University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA

    M. R. Baer

  7. Weill Cornell Medical College, New York, NY, USA

    E. Ritchie & R. T. Silver

  8. Georgetown University Medical Center, Washington, DC, USA

    C. Kessler

  9. Winship Cancer Institute Emory University School of Medicine, Atlanta, GA, USA

    E. Winton

  10. Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy

    M. C. Finazzi & A. Rambaldi

  11. Department of Oncology, University of Milan, Milan, Italy

    A. Rambaldi

  12. CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy

    A. M. Vannucchi

  13. Oncology Department, Palo Alto Medical Foundation Sutter Health, Sunnyvale, CA, USA

    D. Leibowitz

  14. Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA

    D. Rondelli

  15. Duke University School of Medicine, Durham, NC, USA

    M. O. Arcasoy

  16. Oncology Department, John H Stroger Jr. Hospital of Cook County Chicago, Chicago, IL, USA

    R. Catchatourian

  17. Geisinger Medical Center, Danville, PA, USA

    J. Vadakara

  18. Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology, and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, 19, viale Golgi, 27100, Pavia, Italy

    V. Rosti

  19. University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, USA

    E. Hexner

  20. Department of Pathology and Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    J. Tripodi & V. Najfeld

  21. Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    N. Farnoud & R. Rampal

  22. Mayo Medical Laboratories, Rochester, MN, USA

    M. E. Salama

  23. New York Blood Center, New York, NY, USA

    R. S. Weinberg

  24. Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA

    J. D. Goldberg

  25. UT Health San Antonio Cancer Center, San Antonio, TX, USA

    R. Mesa

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  1. J. Mascarenhas
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Correspondence to J. Mascarenhas.

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Conflict of interest

J.M. reports clinical trial research support paid to the institution from Incyte, Roche, Novartis, CTI Biopharma, Janssen, Merck, Promedior, and Celgene; clinical trial steering committee and scientific advisory board member: Roche, CTI Biopharma, Incyte, and Celgene. M.R.B. reports clinical trial research support paid to the institution from Abbvie, AI, Astellas, Forma, Incyte, Kite, and Takeda. M.A. reports research grant support paid to institution from Incyte, CTI Biopharma, Samus Therapeutics, Janssen, and Gilead. R.T.S. reports consultancy and speaker bureau for Pharmaessentia. R.H. reports research support from Roche.

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Mascarenhas, J., Kosiorek, H., Prchal, J. et al. A prospective evaluation of pegylated interferon alfa-2a therapy in patients with polycythemia vera and essential thrombocythemia with a prior splanchnic vein thrombosis. Leukemia 33, 2974–2978 (2019). https://doi.org/10.1038/s41375-019-0524-7

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