Thrombosis in myeloproliferative neoplasms during cytoreductive and antithrombotic drug treatment

: A state-of-the-art lecture titled "Myeloproliferative Neoplasm-associated Thrombosis" was presented at the ISTH congress in 2021. We summarize here the main points of the lecture with two purposes: to report the incidence rates of major thrombosis in polycythemia vera and essential thrombocythemia and to discuss to what extent cytoreductive therapy and antithrombotic drugs have reduced the incidence of these events. Unfortunately, the incidence rate of thrombosis remains high, ranging between 2 and 5/100 person-years. It is likely that new drugs such as interferon and ruxolitinib can be more efficacious given their cytoreductive and anti-inflammatory activities. Despite prophylaxis with vitamin K antagonists and direct oral anticoagulants after venous thrombosis in either common sites or splanchnic or cerebral sites, the incidence rate is still elevated, as high as 4 to 5/100 person-years. Future studies with new drugs or new strategies should consider thrombosis as the primary endpoint or surrogate biomarkers only if previously validated

La comunicazione turistica plurilingue: il Progetto “Museo poliglotta"

Tourism communication, especially since the digital turn, has registered several attempts to open to new forms of multilingualism. For instance, the traditional multilingual experience offered by guided tours and audio guides has now been enhanced by social networking tools. Recent research points to the need of interdisciplinary work at the crossroads of linguistics, media sciences and museum studies to investigate communication strategies and linguistic devices by means of which an international audience of tourists can be addressed and get involved in museums in the digital age. The present paper illustrates the first findings of the project “Museo poliglotta”, a project run by two universities in the Italian towns of Bergamo and Brescia in cooperation with local museums with the goal of producing digital multilingual contents for international museum visitors. The empirical part of the paper describes a workshop activity in which students developed Instagram reels in Italian, German and English on the figure of the well-known Italian composer Gaetano Donizetti. A number of observations lead to the conclusion that synergies between language research and foreign language teaching on the one hand and museum institutions on the other can bring about important benefits for all parties involved, in particular the possibility to offer professionalising training in the academic world and stimuli to innovate and improve multilingual communication in the museum sector

Kunst kindgerecht erklärt – eine Fallstudie zu museumspädagogischen Erklärvideos

As young visitors represent “the museum audience of the future”, museums should be particularly committed to engaging children in museum experiences pursuing a child-oriented approach to art communication and education. The analysis of museum communication from a linguistic perspective seems thus a promising way of exploring the target-group-specificity of museum educational resources explicitly designed for addressing young audiences. Explanatory videos featured on museum websites which present the museum itself or masterpieces of its collections are examples of digital tools employed by museums to introduce children to art and encouraging them to become devoted visitors. The paper presents the findings of a case study of a sample of German and Italian museum explanatory videos for primary school children, aiming at analyzing the linguistic and multimodal strategies used by museums in order to transfer knowledge about art, artists and exhibitions in a child-centered explanatory style. Of particular interest in this context is the question of whether and to what extent these videos encourage a participatory, play-based access to art or enable an experience-oriented approach to art-related contents, as advocated by current trends in museum communication and education

Long-term follow-up of recovered MPN patients with COVID-19

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Neoplàsies mieloproliferatives cròniquesCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Neoplasias mieloproliferativas crónicasCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Chronic myeloproliferative neoplasmsDuring the first wave of SARS-CoV-2 infection a European observational study was launched under the auspices of the European Leukemia Net (ELN), aiming at gathering information about the clinical epidemiology of COVID-19 in patients with chronic myeloproliferative neoplasms (MPN-COVID study).The study was supported by a research grant by the COVID “3×1 project”, BREMBO S.p.A., Bergamo, Italy (TB) and by AIRC 5×1000 call “Metastatic disease: the key unmet need in oncology” to MYNERVA project, #21267 (MYeloid NEoplasms Research Venture AIRC). A detailed description of the MYNERVA project is available at https://progettomynerva.it (AMV, PG). The study was also supported by HARMONY PLUS, which is funded through the Innovative Medicines Initiative (IMI), Europe’s largest public-private initiative aiming to speed up the development of better and safer medicines for patients. The HARMONY Alliance has received funding from IMI 2 Joint Undertaking and is listed under grant agreement No. 945406. This Joint Undertaking receives support from the European Union’s Horizon 2020 Research and Innovation Programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA). IMI supports collaborative research projects and builds networks of industrial and academic experts in order to boost pharmaceutical innovation in Europe

Breakthrough infections in MPN-COVID vaccinated patients

Myeloproliferative diseaseEnfermedad mieloproliferativaMalaltia mieloproliferativaThe study was supported by a research grant by the COVID “3 × 1 project”, BREMBO S.p.A., Bergamo, Italy (T.B.) and by AIRC 5 × 1000 call “Metastatic disease: the key unmet need in oncology” to MYNERVA project, #21267 (MYeloid NEoplasms Research Venture AIRC). A detailed description of the MYNERVA project is available at https://progettomynerva.it (A.M.V., P.G.). The study was also supported by HARMONY PLUS, which is funded through the Innovative Medicines Initiative (IMI), Europe’s largest public–private initiative aiming to speed up the development of better and safer medicines for patients. The HARMONY Alliance has received funding from IMI 2 Joint Undertaking and is listed under grant agreement No. 945406. This Joint Undertaking receives support from the European Union’s Horizon 2020 Research and Innovation Programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA). IMI supports collaborative research projects and builds networks of industrial and academic experts in order to boost pharmaceutical innovation in Europe

Clinical outcomes under hydroxyurea treatment in polycythemia vera: a systematic review and meta-analysis

H ydroxyurea is the standard treatment in high-risk patients with polycythemia vera. However, estimates of its effect in terms of clinical outcomes (thrombosis, bleeding, hematologic transformations and mortality) are lacking. We performed a meta-analysis to determine the absolute risk of events in recent cases of patients under hydroxyurea treatment. We searched for relevant articles or abstracts in the following databases: Medline, EMBASE, clinicaltrials.gov, WHO International Clinical Trials Registry, LILACS. Sixteen studies published from 2008 to 2018 reporting number of events using World Health Organization diagnosis for polycythemia vera were selected. Through a random effect logistic model, incidences, study heterogeneity and confounder effects were estimated for each outcome at different follow ups. Overall, 3,236 patients were analyzed. While incidences of thrombosis and acute myeloid leukemia were stable over time, mortality and myelofibrosis varied depending on followup duration. Thrombosis rates were 1.9%, 3.6% and 6.8% persons/year at median ages 60, 70 and 80 years, respectively. Higher incidence of arterial events was predicted by previous cardiovascular complication. Leukemic transformation incidence was 0.4% persons/year. Incidence of transformation to myelofibrosis and mortality were significantly dependent on age and follow-up duration. For myelofibrosis, rates were 5.0 at five years and 33.7% at ten years; overall mortality was 12.6% and 56.2% at five and ten years, respectively. In conclusion, we provide reliable risk estimates for the main outcomes in polycythemia vera patients under hydroxyurea treatment. These findings can help design comparative clinical trials with new cytoreductive drugs and prove the feasibility of using critical end points for efficacy, such as major thrombosis

Cerebral venous thrombosis and myeloproliferative neoplasms: A three‐center study of 74 consecutive cases

: The recent association of cerebral venous thrombosis (CVT) with COVID-19 vaccinations prompted the current retrospective review of 74 cases of CVT (median age = 44 years, range 15-85; 61% females) associated with myeloproliferative neoplasms (MPNs), seen at the Mayo Clinic, Catholic University of Rome, and University of Florence, between 1991 and 2021. Disease-specific frequencies were 1.3% (39/2893), 1.2% (21/1811) and 0.2% (3/1888) for essential thrombocythemia, polycythemia vera and primary myelofibrosis, respectively. Cerebral venous thrombosis occurred either prior to (n = 20, 27%), at (n = 32, 44%) or after (n = 22) MPN diagnosis. A total of 72% of patients presented with headaches. Transverse (51%), sagittal (43%) and sigmoid sinuses (35%) were involved with central nervous system hemorrhage noted in 10 (14%) patients. In all, 91% of tested patients harbored JAK2V617F. An underlying thrombophilic condition was identified in 19 (31%) cases and history of thrombosis in 10 (14%). Treatment for CVT included systemic anticoagulation alone (n = 27) or in conjunction with aspirin (n = 24), cytoreductive therapy (n = 14), or both (n = 9). At a median follow-up of 5.1 years (range 0.1-28.6), recurrent CVT was documented in three (4%) patients while recurrent arterial and venous thromboses and major hemorrhage were recorded in 11%, 9% and 14%, respectively. Follow-up neurological assessment revealed headaches (n = 9), vision loss (n = 1) and cognitive impairment (n = 1). The current study lends clarity to MPN-associated CVT and highlights its close association with JAK2V617F, younger age and female gender. Clinical features that distinguish COVID vaccine-related CVT from MPN-associated CVT include, in the latter, lower likelihood of concurrent venous thromboses and intracerebral hemorrhage; as a result, MPN-associated CVT was not fatal