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Blood, 15 July 2007, Vol. 110, No. 2, pp. 485-489.
Prepublished online as a Blood First Edition Paper on April 10, 2007; DOI 10.1182/blood-2007-01-071068.
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Submitted January 29, 2007
Accepted April 4, 2007
Increased risk of pregnancy complications in patients with essential thrombocythemia carrying the JAK2(V617F) 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
Department of Hematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
Departement of Medical and Surgical Sciences CLOPD, University of Padova Medical School, Padova, Italy
Division of Hematology, Ospedale Niguarda Ca' Granda, Milan, Italy
Department of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
* Corresponding author; email: f.passamonti{at}smatteo.pv.it.
Essential thrombocythemia (ET) may occur in women of childbearing age. To investigate the risk of pregnancy complications, we studied 103 pregnancies occurred in 62 women with ET. Two-tailed Fisher exact test showed that pregnancy outcome was independent from that of a previous pregnancy. The rate of live birth was 64%, and 51% of pregnancies were uneventful. Maternal complications occurred in 9%, while fetal complications occurred in 40% of pregnancies. The Mantel-Haenszel method showed that fetal loss in women with ET was 3.4-fold higher (95% CI 3-3.9; P<.0001) than that of the general population. Half of the women studied carried the JAK2 (V617F) mutation, and multivariate logistic regression model identified this mutation as an independent predictor of pregnancy complications (P =.01). Neither the platelet count nor the leukocyte count were risk factors. JAK2 (V617F)-positive patients had an odds ratio of 2.02 (95% CI: 1.1-3.8) of developing complications in comparison with JAK2 (V617F)-negative patients. Aspirin did not prevent complication in JAK2 (V617F)-positive patients and appeared to worse outcome in JAK2 (V617F)-negative. A relationship was found between JAK2 (V617F) and fetal loss (P=.05). This study indicates that patients carrying the JAK2 (V617F) mutation have higher risk of developing pregnancy complications.
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