All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit the MPN Advocates Network.

The MPN Hub uses cookies on this website. They help us give you the best online experience. By continuing to use our website without changing your cookie settings, you agree to our use of cookies in accordance with our updated Cookie Policy

Introducing

Now you can personalise
your MPN Hub experience!

Bookmark content to read later

Select your specific areas of interest

View content recommended for you

Find out more
  TRANSLATE

The MPN Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the MPN Hub cannot guarantee the accuracy of translated content. The MPN Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.

Steering CommitteeAbout UsNewsletterContact
LOADING
You're logged in! Click here any time to manage your account or log out.
LOADING
You're logged in! Click here any time to manage your account or log out.
2024-09-06T12:58:31.000Z

Aspirin therapy and risk of pregnancy loss in patients with ET

Sep 6, 2024
Share:
Learning objective: After reading this article, learners will be able to cite a new clinical development in essential thrombocythemia.

A retrospective analysis assessed the fetal and maternal outcomes and associated factors of 200 pregnancies in 100 patients with essential thrombocythemia (ET), including the effect of aspirin treatment.1 Results from this analysis were published in the American Journal of Hematology by Gangat  et al.1 

Key learnings

The live birth rate was 72%, with most of the unintentional fetal losses occurring in the first trimester (24%). Fetal complications other than pregnancy loss were reported in 7% of patients, including preterm birth (3%), intrauterine growth restriction (3%), and neonatal intensive care admission (2%). Maternal complications occurred in 13% of patients, and included major hemorrhage (7%), preeclampsia (6%), venous thrombosis (1%), hemolysis with elevated liver enzymes and low platelets (1%), and placental abruption (0.5%).

Treatment with aspirin (n = 135) when compared with no treatment or treatment other than aspirin (n = 65) reduced the risk of pregnancy loss (16% vs 49%; p < 0.01) and first-trimester pregnancy loss (14% vs 45%; p < 0.01) in patients with ET, including lower incidences of first-trimester pregnancy loss in patients with mutated JAK2 (18% vs 50%; p < 0.01) or mutated CALR (8% vs 43%; p < 0.01). This suggests aspirin should be considered a standard preventive measure in managing pregnancies in patients with ET.

Aspirin use was also associated with a lower incidence of maternal venous thrombosisduring pregnancy in patients with ET (0% vs 3%, p = 0.03), reinforcing its dual protective role in both fetal and maternal outcomes.

Systemic anticoagulation, either antepartum or postpartum, did not significantly reducefetal or maternal complications, indicating that aspirin might be sufficient in most cases and limiting the need for more intensive anticoagulation strategies.

First-trimester unintentional fetal loss rates were higher in patients with prior pregnancy loss (43% vs 18%; p < 0.01) and patients with diabetes mellitus (DM; 67% vs 23%; p = 0.02) than in patients without. In addition, DM and CALR mutations were key predictors of maternal complications, with DM linked to preeclampsia (33% vs 5%; p = 0.03) and CALR mutations associated with an increased risk of hemorrhage (13% vs 4%; p = 0.05). This highlights the need for close monitoring and tailored management strategies in these higher-risk subgroups.

  1. Gangat N, Signh A, Ilyas R, et al. Aspirin therapy is associated with a lower risk of pregnancy loss in both JAK2- and CALR-mutated essential thrombocythemia–A Mayo Clinic study of 200 pregnancies. Am J 2024. Online ahead of print. DOI: 10.1002/ajh.27416

Your opinion matters

As a result of this content, I commit to reviewing the latest data with luspatercept to guide my treatment of myelofibrosis-associated anemia.
13 votes - 32 days left ...

Newsletter

Subscribe to get the best content related to MPN delivered to your inbox