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Increased risk of pregnancy complications in patients with essential thrombocythemia carrying the JAK2 (617V>F) mutation

Francesco Passamonti, Maria Luigia Randi, Elisa Rumi, Ester Pungolino, Chiara Elena, Daniela Pietra, Margherita Scapin, Luca Arcaini, Fabiana Tezza, Remigio Moratti, Cristiana Pascutto, Fabrizio Fabris, Enrica Morra, Mario Cazzola and Mario Lazzarino

Article Figures & Data

Figures

  • Figure 1

    Odds ratios for the prevalence of risk factors in patients with pregnancy complications. ORs were 0.9 (95% CI [bar]: 0.5-1.7) for age 35 years or younger, 0.8 (95% CI: 0.4-1.7) for parity, 1 (95% CI: 0.5-2.0) for the presence of abortion risk factor, 1.2 (95% CI: 0.7-2.3) for the presence of thrombophilia, 1 (95% CI: 0.5-2.2) for thrombocytosis exceeding 1000 × 109/L, 0.7 (95% CI: 0.4-1.3) for leukocytosis exceeding 10 × 109/L, 2 (95% CI: 1.1-3.8) for the presence of JAK2 (617V>F) mutation, and 0.9 (95% CI: 0.5-1.6) for antiplatelet therapy during pregnancy. The JAK2 (617V>F) mutation was a significant risk factor for pregnancy complications.

Tables

  • Table 1

    Demographic and hematologic characteristics at first pregnancy of 58 women with ET

    Characteristic
    No. of patients58
    No. of pregnancies96
    Median age at diagnosis, y (range)28 (18-44)
    Median age at conception, y (range)32 (18-44)
    No. with at least 1 abortion risk factor (%)*10/58 (17)
    No. with thrombophilia15/46 (33)
        Factor V Leiden mutation; +/−1
        Methylenetetrahydrofolate reductase mutation; +/+7
        Prothrombin mutation; +/−1
        Hyperhomocysteinemia4
        Antiphospholipid antibody2
    No. with JAK2 (617V>F) mutation (%)24/49 (49)
    Median JAK2 (617V>F) mutation burden, % (range)10.1 (3.9-24.2)
    Median WBC count at pregnancy, × 109/L (range)7.1 (4.2-15.3)
    Median hemoglobin level at pregnancy, g/L (range)131 (115-154)
    Median platelet count at pregnancy, × 109/L (range)601 (266-1660)
    • * Abortion risk factors include overweight, hypertension, high cholesterol level, diabetes, current smoking, and thyroid diseases.

    • +/+ indicates homozygous; +/−, heterozygous.

    • Hyperhomocysteinemia, more than 13.9 μM.

  • Table 2

    Complications of 96 pregnancies in 58 patients with ET

    Pregnancy complicationsNo. of pregnancies (%)
    Total events47 (49)
    Fetal loss34 (36)
        First-trimester abortion27
        Second-trimester abortion4
        Stillbirth3
    Intrauterine growth retardation4 (4)
    Maternal complications9 (9)
        Pre-eclampsia5
        Arterial hypertension4