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 - Université de Rennes Access content directly
Journal Articles Clinical and experimental rheumatology Year : 2022

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

Vincent Jachiet
Benoit de Renzis
  • Function : Author
Diane Kottler
  • Function : Author
Laurent Voillat
  • Function : Author
Sophie Dimicoli-Salazar
  • Function : Author
Anne Banos
  • Function : Author
Marie-Paule Chauveheid
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Jean-François Alexandra
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Eric Grignano
  • Function : Author
François Liferman
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Mathilde Laborde
  • Function : Author
Jonathan Broner
  • Function : Author
Marc Michel
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Olivier Lambotte
  • Function : Author
Kamel Laribi
  • Function : Author
Marie-Dominique Venon
  • Function : Author
Bertrand Dussol
  • Function : Author
Nihal Martis
  • Function : Author
Sylvain Thepot
  • Function : Author
Sophie Park
  • Function : Author
David Couret
  • Function : Author
Marielle Roux-Sauvat
  • Function : Author
Cécile Bally
  • Function : Author
Joris Galland
  • Function : Author
Anne Parcelier
  • Function : Author
Pierre Peterlin
  • Function : Author
Judith Cohen-Bittan
  • Function : Author
Alexis Regent
  • Function : Author
Felix Ackermann
  • Function : Author
Julien Le Guen
  • Function : Author
Caroline Algrin
  • Function : Author
Pierre Charles
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Etienne Daguindau
  • Function : Author
Xavier Puechal
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Bertrand Dunogue
  • Function : Author
Claire Blanchard-Delaunay
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Odile Beyne-Rauzy
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Vincent Grobost
  • Function : Author
Jean Schmidt
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Thomas Le Gallou
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Georgeta Dubos-Lascu
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Anne Sonet
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Guillaume Denis
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Frédérique Roy-Peaud
  • Function : Author
Pierre Fenaux
  • Function : Author
Lionel Adès
Olivier Fain
Arsène Mekinian

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.
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Dates and versions

hal-03968172 , version 1 (01-02-2023)

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Marie Péan de Ponfilly-Sotier, Vincent Jachiet, Ygal Benhamou, Constance Lahuna, Benoit de Renzis, et al.. 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. Clinical and experimental rheumatology, 2022, 40 (7), pp.1336-1342. ⟨10.55563/clinexprheumatol/nbn38d⟩. ⟨hal-03968172⟩
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