Kidney Dysfunction Is Associated with Thrombosis and Disease Severity in Myeloproliferative Neoplasms: Implications from the German Study Group for MPN Bioregistry

Cancers, vol. 13, pp. 4086

Abstract

Inflammation-induced thrombosis represents a severe complication in patients with myeloproliferative neoplasms (MPN) and in those with kidney dysfunction. Overlapping disease-specific attributes suggest common mechanisms involved in MPN pathogenesis, kidney dysfunction, and thrombosis. Data from 1420 patients with essential thrombocythemia (ET, 33.7%), polycythemia vera (PV, 38.5%), and myelofibrosis (MF, 27.9%) were extracted from the bioregistry of the German Study Group for MPN. The total cohort was subdivided according to the calculated estimated glomerular filtration rate (eGFR, (mL/min/1.73 m2)) into eGFR1 (≥90, 21%), eGFR2 (60–89, 56%), and eGFR3 (<60, 22%). A total of 29% of the patients had a history of thrombosis. A higher rate of thrombosis and longer MPN duration was observed in eGFR3 than in eGFR2 and eGFR1. Kidney dysfunction occurred earlier in ET than in PV or MF. Multiple logistic regression analysis identified arterial hypertension, MPN treatment, increased uric acid, and lactate dehydrogenase levels as risk factors for kidney dysfunction in MPN patients. Risk factors for thrombosis included arterial hypertension, non-excessive platelet counts, and antithrombotic therapy. The risk factors for kidney dysfunction and thrombosis varied between MPN subtypes. Physicians should be aware of the increased risk for kidney disease in MPN patients, which warrants closer monitoring and, possibly, early thromboprophylaxis.

Authors 24

1. Judith Gecht Aachen Department of Hematology, Oncology Faculty of Medicine

   RWTH Aachen University

   Affiliation as printed

   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

   Department of Hematology, Oncology, Hemostaseology and SCT, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany

2. Ioannis Tsoukakis Aachen Department of Hematology, Oncology Faculty of Medicine

   Goethe University Frankfurt · RWTH Aachen University

   Affiliation as printed

   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

   Department of Hematology, Oncology, Hemostaseology and SCT, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany

   Department of Medicine, Hematology/Oncology, Goethe-University, 60590 Frankfurt am Main, Germany

3. Kim Kricheldorf Aachen Department of Hematology, Oncology Faculty of Medicine

   RWTH Aachen University

   Affiliation as printed

   Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

   Department of Hematology, Oncology, Hemostaseology and SCT, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany

4. Frank Stegelmann

   University Hospital Ulm

   Affiliation as printed

   Department of Internal Medicine III, University Hospital of Ulm, 89081 Ulm, Germany

5. Martine Klausmann

   Aschaffenburg University of Applied Sciences

   Affiliation as printed

   Studienzentrum Aschaffenburg, 63739 Aschaffenburg, Germany

6. Martin Grießhammer

   Johannes Wesling Klinikum Minden

   Affiliation as printed

   Johannes Wesling Medical Center, University Clinic for Hematology, Oncology, Hemostaseology, and Palliative Care (UKRUB), University of Bochum, 32429 Minden, Germany

7. Wiebke Hollburg
   Affiliation as printed

   HOPA-Hämatologisch-Onkologische Praxis Altona, 22767 Hamburg, Germany

8. Joachim Rudolf Göthert

   Essen University Hospital · Stiftung Universitätsmedizin Essen

   Affiliation as printed

   Department of Hematology and Stem Cell Transplantation, University Hospital Essen, 45147 Essen, Germany

9. Katja Sockel

   University Hospital Carl Gustav Carus · Technische Universität Dresden

   Affiliation as printed

   Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, TU Dresden, 01307 Dresden, Germany

10. Florian Heinrich Heidel

    Universitätsmedizin Greifswald · Universität Greifswald · Jena University Hospital

    Affiliation as printed

    Department of Hematology/Oncology, Clinic of Internal Medicine II, Jena University Hospital, 07747 Jena, Germany

    Innere Medizin C, Universitätsmedizin Greifswald, 17475 Greifswald, Germany

11. Norbert Gattermann

    Heinrich Heine University Düsseldorf

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

    Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany

12. Christoph Maintz
    Affiliation as printed

    MWZ-West Hematology-Oncology, 52146 Würselen, Germany

13. Haifa Kathrin Al‐Ali

    University Hospital in Halle

    Affiliation as printed

    Department of Hematology/Oncology, University Hospital Halle, 06120 Halle, Germany

14. Uwe Platzbecker

    University Hospital Leipzig

    Affiliation as printed

    Department of Hematology and Cellular Therapy, Medical Clinic and Policlinic I, Leipzig University Hospital, 04103 Leipzig, Germany

15. Mathias Hänel

    Klinikum Chemnitz

    Affiliation as printed

    Department of Internal Medicine III, Klinikum Chemnitz, 09116 Chemnitz, Germany

16. Stefani Barbara Parmentier

    Rems-Murr-Klinikum · St. Claraspital

    Affiliation as printed

    Department of Hematology and Oncology, Rems-Murr-Klinikum Winnenden, 71364 Winnenden, Germany

    Onkologie/Hämatologie, Claraspital Tumorzentrum Basel, 4058 Basel, Switzerland

17. Martin Bommer

    Alb Fils Kliniken

    Affiliation as printed

    Department of Hematology, Oncology, Infectious Diseases and Palliative Care, Alb-Fils-Kliniken, 73035 Göppingen, Germany

18. Heike Luise Pahl

    University of Freiburg · University Medical Center Freiburg

    Affiliation as printed

    Department of Medicine I, Hematology and Oncology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany

19. Fabian Lang

    Goethe University Frankfurt

    Affiliation as printed

    Department of Medicine, Hematology/Oncology, Goethe-University, 60590 Frankfurt am Main, Germany

20. Martin Kirschner Aachen Department of Hematology, Oncology Faculty of Medicine

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and SCT, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany

21. Susanne Isfort Aachen Department of Hematology, Oncology Faculty of Medicine

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and SCT, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany

22. Tim H. Brümmendorf Aachen Department of Hematology, Oncology Faculty of Medicine

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and SCT, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany

23. Konstanze Döhner

    University Hospital Ulm

    Affiliation as printed

    Department of Internal Medicine III, University Hospital of Ulm, 89081 Ulm, Germany

24. Steffen Koschmieder corresponding Aachen Department of Hematology, Oncology Faculty of Medicine

    RWTH Aachen University

    Affiliation as printed

    Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), 52074 Aachen, Germany

    Department of Hematology, Oncology, Hemostaseology and SCT, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany