Abstract
Philadelphia chromosome-negative myeloproliferative neoplasms include polycythemia
vera, essential thrombocythemia, and myelofibrosis. They are associated with increased
thrombotic events, and the primary goal of therapy, in particular those with polycythemia
vera and essential thrombocythemia, is the prevention of thrombotic complications
typically with antiplatelet therapy and/or cytoreduction. While several patient-,
disease-, and genomic-related factors have been identified to influence thrombotic
risks, there are no routine laboratory investigations to date that are sufficiently
accurate to assess the underlying procoagulant state and predict the thrombotic risks.
Conventional coagulation testing only measures time to clot formation and cannot reliably
predict bleeding and thrombotic risks. Global coagulation assays such as thromboelastography,
thrombin, and fibrin generation may provide a more thorough assessment of hemostatic
function. Thromboelastography and thromboelastometry are viscoelastic tests which
measure the mechanical properties of the hemostatic process, including the global
dynamics of clot formation, stabilization, and dissolution. While viscoelastic testing
is gaining traction in the investigations of coagulopathies and goal-directed blood
product replacement in trauma and massive transfusion settings, the role of these
assays in thrombosis is less well defined. Here, we provide a review of the current
evidence of the role of viscoelastic testing in myeloproliferative neoplasm, particularly
in the thrombotic risk assessment.
Keywords
viscoelastic test - thromboelastography - thromboelastometry - thrombosis - myeloproliferative
neoplasm
