Gender and Vascular Complications in the JAK2 V617F-Positive Myeloproliferative Neoplasms

Abstract

We previously found that gender influenced the JAK2 V617F allele burden, but it is unknown whether this gender difference in molecular epidemiology influences complications in the myeloproliferative neoplasms (MPNs). Historically, vascular complications represented the most common cause of mortality in polycythemia vera and essential thrombocytosis and contributed to morbidity in primary myelofibrosis. To determine the influence of gender on vascular complications, we retrospectively analyzed associations between gender and vascular complications. Despite their younger age, less prevalent dyslipidemia or smoking history, lower white blood counts, and lower JAK2 V617F allele burden, women had higher rates of abdominal venous thrombosis and comparable rates of all vascular complications. Vascular risk is currently not easily stratified by MPN-disease burden or traditional risk factors. Our analysis contributes to growing literature emphasizing gender differences in the MPN and further supports the important impact of individual and host variation on MPN clinical manifestations, and especially vascular risk.

Figure 1

Major and minor vascular events through the course of the disease. The timing of vascular complication was known for 13 men and 41 women. In both men and women, vascular complications often lead to an official diagnosis of a myeloproliferative neoplasm (complication at year 0). Further, vascular complications predominantly occurred in the first decade of disease in both men and women. Of the 15 women with vascular complications at year 0, 9 had abdominal venous thrombosis.