ISSN (print) 1997-6933     ISSN (online) 2500-2139
Vol. 18 No. 2 (2025), MYELOID TUMORS
Vol. 18 No. 2 (2025)
MYELOID TUMORS

Esophagogastric Bleedings in Patients with Ph-Negative Myeloproliferative Neoplasms and Extrahepatic Portal Hypertension

Published 01.04.2025
Pavel Artemovich Batrov
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0001-5379-4981
K.I. Danishian
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0003-3662-9751
E.P. Sysoeva
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-5056-9540
K.R. Sabirov
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0003-3677-0480
O.M. Averbukh
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0009-0007-2101-374X
O.A. Soboleva
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0001-9879-2664
E.A. Kitsenko
BV Petrovskii Russian Research Center for Surgery, 2 Abrikosovskii per., Moscow, Russian Federation, 119991
https://orcid.org/0000-0002-8268-3129
E.A. Lukina
National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167
https://orcid.org/0000-0002-8774-850X
2025-2
PDF_2025-18-2-163-170 (Russian)

Keywords

Ph-negative myeloproliferative neoplasms
thrombotic complications
extrahepatic portal hypertension
esophagogastric variceal bleeding
splenectomy

How to Cite

Batrov P.A., Danishian K.I., Sysoeva E.P., Sabirov K.R., Averbukh O.M., Soboleva O.A., Kitsenko E.K., Lukina E.A. Esophagogastric Bleedings in Patients with Ph-Negative Myeloproliferative Neoplasms and Extrahepatic Portal Hypertension. Clinical Oncohematology. 2025;(2):163–170. doi:10.21320/2500-2139-2025-18-2-163-170.
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Abstract

AIM. To assess the treatment outcomes in esophagogastric bleeding patients with Ph-negative myeloproliferative neoplasms (MPN) and extrahepatic portal hypertension caused by thrombotic complications.

MATERIALS & METHODS. The present prospective clinical trial performed in the surgical department of the National Research Center for Hematology from 2013 to 2024 enrolled 52 patients with Ph-negative MPNs and extrahepatic portal hypertension caused by total portal vein thrombosis. The median age of patients was 45 years (range 25–68 years). Young (≤ 40 years) and middle-aged (≤ 60 years) patients predominated: 16 (30.8 %) and 31 (59.6 %), respectively. There were 5 (9.6 %) elderly (> 60 years) patients. The V617F mutation in JAK2 was detected in 41 (78.8 %) out of 52 patients.

RESULTS. Splenectomy was performed in 49 patients, 41 (78.8 %) out of them also underwent gastrotomy as well as esophageal/gastric variceal ligation. Gastrotomy was not carried out in 10 (19.2 %) out of 52 patients. Laparotomy with gastrotomy along with esophageal and gastric variceal ligation (without splenectomy) was performed in 3 (5.8 %) patients. Repeated bleedings were registered in 2 of them, which required further splenectomy. Overall incidence of postoperative complications was 21 %. Long-term rebleedings reported in 7 (13.5 %) patients were treated non-surgically. The 5-year overall survival in the total group (n = 52) was 90.1 %. At later stages of Ph-negative MPNs, 5 (9.6 %) deaths were registered as a result of the blast transformation of the disease (n = 3) and thrombohemorrhagic complications (n = 2).

CONCLUSION. Patients with Ph-negative MPNs and extrahepatic portal hypertension caused by portal vein thrombosis represent most complicated cases. However, surgical procedures, such as splenectomy combined with gastrotomy and esophageal/gastric variceal ligation, considerably improve long-term treatment outcomes despite a relatively high incidence of postoperative complications (thrombotic, hemorrhagic, purulent, and inflammatory ones).

PDF_2025-18-2-163-170 (Russian)

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