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Chronic myeloproliferative neoplasms

Reply to: Second primary malignancies in myeloproliferative neoplasms and the role of aspirin

Leukemia volume 34, pages 1208–1209 (2020)Cite this article

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The letter of Lucijanic et al. [1] raises the question of a possible carcinogenic role of aspirin (ASA) in myeloproliferative neoplasms (MPN). The concern is based on the results of the ASPREE randomized clinical trial (Aspirin in Reducing Events in the Elderly) that investigated whether the daily use of 100 mg of enteric-coated aspirin would prolong the healthy life span of older adults [2]. The primary end point of ASPREE was disability-free survival, defined as survival free of dementia or persistent physical disability. The use of low-dose aspirin did not impact significantly compared with placebo in reducing the rate of primary end point after a median of 4.7 years of follow-up. Surprisingly, and in contrast to meta-analyses of previous randomized prevention trials of aspirin that showed a protective effect of aspirin on cancer-related death [3], the above study reported an increased cumulative incidence of cancer-related death in healthy elderly in comparison to placebo (Hazard Ratio: 1.31; 95% CI 1.10–1.56) and this event was only minimally related to major bleeding.

Lucijanic et al. are wondering whether ASA can be in some way involved in the process of oncogenesis in patients with MPN and if our recently published MPN-K study [4] contains information regarding the association between ASA and the occurrence of secondary tumors in MPN.

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References

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MPN-K authors

Tiziano Barbui1, Arianna Ghirardi1, Arianna Masciulli1, Alessandra Carobbio1, Francesca Palandri5, Nicola Vianelli2, Valerio De Stefano4, Silvia Betti4, Ambra Di Veroli6, Alessandra Iurlo7, Daniele Cattaneo7, Guido Finazzi8, Massimiliano Bonifacio9, Luigi Scaffidi9, Andrea Patriarca10,11, Elisa Rumi12,13, Ilaria Carola Casetti12, Clemency Stephenson14, Paola Guglielmelli2, Elena Maria Elli15, Miroslava Palova16, Laura Bertolotti17, Daniel Erez18, Montse Gomez19, Kai Wille20, Manuel Perez-Encinas21, Francesca Lunghi22, Anna Angona23, Maria Laura Fox24, Eloise Beggiato25, Giulia Benevolo26, Giuseppe Carli27, Rossella Cacciola28, Mary Frances McMullin29, Alessia Tieghi30, Valle Recasens31, Susanne Isfort32, Monia Marchetti3, Martin Griesshammer20, Alberto Alvarez-Larran33, Alessandro Maria Vannucchi2, Alessandro Rambaldi8

Author information

Authors and Affiliations

  1. FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Tiziano Barbui, Arianna Ghirardi, Tiziano Barbui, Arianna Ghirardi, Arianna Masciulli & Alessandra Carobbio

  2. CRIMM-Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliera Universitaria Careggi, Dept Experimental and Clinical medicine, and Denothe Center, University of Florence, Florence, Italy

    Alessandro Maria Vannucchi, Nicola Vianelli, Paola Guglielmelli & Alessandro Maria Vannucchi

  3. Oncology Unit, Cardinal Massaia Hospital, Asti, Italy

    Monia Marchetti & Monia Marchetti

  4. Institute of Hematology, Catholic University, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy

    Valerio De Stefano, Valerio De Stefano & Silvia Betti

  5. Institute of Hematology “L. and A. Seràgnoli”, S. Orsola-Malpighi Hospital, Bologna, Italy

    Francesca Palandri

  6. Rete laziale MPN, Roma, Italy

    Ambra Di Veroli

  7. Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Alessandra Iurlo & Daniele Cattaneo

  8. Hematology Division, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Guido Finazzi & Alessandro Rambaldi

  9. Department of Medicine, Section of Hematology, University of Verona, Verona, Italy

    Massimiliano Bonifacio & Luigi Scaffidi

  10. Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

    Andrea Patriarca

  11. AOU “Maggiore della Carità”, Novara, Italy

    Andrea Patriarca

  12. Department of molecular Medicine, University of Pavia, Pavia, Italy

    Elisa Rumi & Ilaria Carola Casetti

  13. Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy

    Elisa Rumi

  14. Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    Clemency Stephenson

  15. Hematology Division, Ospedale San Gerardo, ASST Monza, Italy

    Elena Maria Elli

  16. Department of Hemato-oncology, University Hospital Olomouc, Olomouc, Czech Republic

    Miroslava Palova

  17. S.C. Ematologia, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy

    Laura Bertolotti

  18. Hematology Institute and Blood Bank, Meir Medical Center, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Daniel Erez

  19. Hematology Department, Hospital Clínico Universitario, Valencia, Spain

    Montse Gomez

  20. University Clinic for Hematology and Oncology Minden, University of Bochum, Bochum, Germany

    Kai Wille & Martin Griesshammer

  21. Hematology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain

    Manuel Perez-Encinas

  22. Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy

    Francesca Lunghi

  23. Hematology Department, Hospital del Mar, Barcelona, Spain

    Anna Angona

  24. Hematology Department, Hospital Universitario Vall d’Hebron, Barcelona, Spain

    Maria Laura Fox

  25. Unit of Hematology, Department of Oncology, University of Torino, Torino, Italy

    Eloise Beggiato

  26. Hematology Division, Città della Salute e della Scienza Hospital, Torino, Italy

    Giulia Benevolo

  27. Hematology Division, San Bortolo Hospital, Vicenza, Italy

    Giuseppe Carli

  28. Haemostasis Unit, Department of Clinical and Experimental Medicine, “Policlinico-Vittorio Emanuele” Hospital, University of Catania, Catania, Italy

    Rossella Cacciola

  29. Queen’s University, Belfast, UK

    Mary Frances McMullin

  30. Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy

    Alessia Tieghi

  31. Hematology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain

    Valle Recasens

  32. Department of oncology, hematology, hemostaseology and stem cell transplantation, University Hospital RWTH Aachen, Aachen, Germany

    Susanne Isfort

  33. Hematology Department, Hospital Clínic, Barcelona, Spain

    Alberto Alvarez-Larran

Authors
  1. Tiziano Barbui
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  2. Arianna Ghirardi
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  3. Alessandro Maria Vannucchi
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  4. Monia Marchetti
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  5. Valerio De Stefano
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Consortia

on behalf of MPN-K authors

  • Tiziano Barbui
  • , Arianna Ghirardi
  • , Arianna Masciulli
  • , Alessandra Carobbio
  • , Francesca Palandri
  • , Nicola Vianelli
  • , Valerio De Stefano
  • , Silvia Betti
  • , Ambra Di Veroli
  • , Alessandra Iurlo
  • , Daniele Cattaneo
  • , Guido Finazzi
  • , Massimiliano Bonifacio
  • , Luigi Scaffidi
  • , Andrea Patriarca
  • , Elisa Rumi
  • , Ilaria Carola Casetti
  • , Clemency Stephenson
  • , Paola Guglielmelli
  • , Elena Maria Elli
  • , Miroslava Palova
  • , Laura Bertolotti
  • , Daniel Erez
  • , Montse Gomez
  • , Kai Wille
  • , Manuel Perez-Encinas
  • , Francesca Lunghi
  • , Anna Angona
  • , Maria Laura Fox
  • , Eloise Beggiato
  • , Giulia Benevolo
  • , Giuseppe Carli
  • , Rossella Cacciola
  • , Mary Frances McMullin
  • , Alessia Tieghi
  • , Valle Recasens
  • , Susanne Isfort
  • , Monia Marchetti
  • , Martin Griesshammer
  • , Alberto Alvarez-Larran
  • , Alessandro Maria Vannucchi
  •  & Alessandro Rambaldi

Corresponding author

Correspondence to Tiziano Barbui.

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Conflict of interest

TB has been a speaker and consultant for Novartis and he has received research grant from AOP Orphan. AMV has been a speaker for Novartis, Celgene, and Shire and participated to advisory boards of Celgene, Incyte, Novartis. MM has received honoraria for advisory boards and lectures at sponsored meetings from Celgene, Amgen, Janssen, Gilead, and Novartis. VDS has received consulting and lecture fees from Amgen, Celgene, Novartis, and institutional research grants from Bayer and Novartis. AG declares that she has no conflict of interest.

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Members of MPN-K authors are listed at the end of the paper.

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Barbui, T., Ghirardi, A., Vannucchi, A.M. et al. Reply to: Second primary malignancies in myeloproliferative neoplasms and the role of aspirin. Leukemia 34, 1208–1209 (2020). https://doi.org/10.1038/s41375-019-0616-4

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  • DOI: https://doi.org/10.1038/s41375-019-0616-4

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