Z Gastroenterol 2015; 53 - A2_48
DOI: 10.1055/s-0035-1568020

γ-GT is associated with splanchnic thrombotic events, CRP predicts survival in patients with myeloproliferative neoplasms

J Görtzen 1, L Hunka 1, M Vonnahme 2, A Kaifie 4, R Fimmers 3, C Jansen 1, A Heine 2, J Lehmann 1, P Brossart 2, CP Strassburg 1, S Koschmieder 4, D Wolf 2, J Trebicka 1
  • 1University of Bonn, Department of Internal Medicine I, Bonn, Germany
  • 2University of Bonn, Department of Internal Medicine III, Bonn, Germany
  • 3University of Bonn, Department of Biometrics, Informatics and Epidemiology, Bonn, Germany
  • 4RWTH Aachen University, Department of Medicine (Hematology, Oncology, Hemostaseology, and SCT), Aachen, Germany

Background:

Myeloproliferative neoplasms (MPN) are associated with an increased risk of thrombotic events, especially in polycythaemia vera (PV) and essential thrombocythaemia (ET). Thrombosis of splanchnic vessels (SVT) may lead to portal hypertension and varices with increased bleeding risk rendering anticoagulation difficult. The identification of risk factors for SVT development might improve the management of MPN patients. In this study, we aimed to identify risk factors for SVT in MPN patients.

Methods:

The retrospectively analysed training cohort included 86 MPN patients which were referred to our hospital between 2009 and 2014, and 40 SVT patients without MPN. 86 patients suffered from MPN (PV n = 18, ET n = 16, MF n = 40, undetermined n = 12) and 40 patients with SVT but without MPN. Clinical and laboratory data were collected and statistically analysed. The prognostic relevance of identified risk factors was validated using a validation cohort of 181 patients from the MPN registry of the Study Alliance of Leukemia.

Results:

In the training cohort, 33 patients (38.4%) with MPN had SVT compared to 76 patients (40.2%) in the validation cohort. Patients with SVT had higher AST, ALT and γ-GT values (p < 0.05). There was no difference between AST, ALT and γ-GT in SVT patients with and without MPN. We further evaluated the MPN patients of the training and validation cohort regarding risk factors for survival and SVT development. In univariate analysis, γ-GT, CRP and bilirubin were associated with the presence of splanchnic vein thrombosis (p < 0.05). In multivariate analysis, γ-GT was a risk factor for the presence of SVT in MPN patients (p < 0.05). LDH, γ-GT and CRP were associated with patient survival in univariate analysis. CRP was also associated with patient survival in multivariate analysis.

Conclusions:

Elevated γ-GT in patients with MPN might be an indicator for splanchnic vein thrombosis and should therefore lead to further diagnostic examination in these patients.

Corresponding author: Görtzen, Jan

E-Mail: jan.goertzen@ukb.uni-bonn.de