Correlation Between PAI-1 Gene 4G/5G Polymorphism and the Risk ofThrombosis in Ph Chromosome-Negative MyeloproliferativeNeoplasms

摘要

Thrombosis has been recognized as one of the most significant risk factors ofhigh mortality and disability in patients with Philadelphia (Ph) chromosomenegative myeloproliferative neoplasms (MPNs). However, the risk factors ofthrombotic events in these patients have not been completely understood. In thisstudy, the clinical data of 58 patients with Ph-MPNs were obtained and analyzed,including 34 cases of essential thrombocytopenia (ET), 23 thrombotic eventshappened in 21 (36%) patients, among which 60% (14 of 23) with cerebralinfarction, 17% (4 of 23) with coronary heart disease and 23% (5 of 23) withvenous thrombosis. There were no significant differences in age, sex, and bloodcell count between polycythemia vera (PV) and ET patients who have experiencedthrombotic events and those who have not. In ET patients, the incidence ofthrombotic events in plasminogen activator inhibitor-1 (PAI-1) genotype 4G4G wassignificantly higher than that in genotype 4G5G and genotype 5G5G(P < .05). The incidence of thrombotic events in PV andET patients with infection was higher than those without infection(P < .05). Using logistic regression analysis, we foundthat PAI-1 genotype 4G4G and infection were associated with thrombotic events(odds ratio 6.744, 95% CI: 1.195-38.056 and 15.641 95% CI: 3.327-73.522). The4G/4G polymorphism of PAI-1 gene and infection are independent risk factors ofthrombotic events in patients with Ph-MPNs. PAI-1 gene 4G4G and infection in ETand PV patients with Janus kinase 2 (JAK2) V617F mutation were shown to be highrisk of thrombotic events. Therefore, clinical doctors should put more attentionon PAI-1 genotype 4G4G and infection in JAK2 V617F mutated patients with Ph-MPNsto prevent the thrombosis.